When a medical bill goes to collections, don't ignore it and don't pay right away. First, check that you really owe the amount: the debt collector must send you validation information, and you generally have 30 days after you get it to dispute the debt in writing. While you check, compare the bill with your Medicare notice, ask the original provider about errors and financial assistance, and keep copies of everything.
What happens when a medical bill is sent to collections?
A doctor's office or hospital may hand an unpaid bill to a collection agency, or sell the debt to a debt buyer. From then on, letters and calls usually come from the collector instead of the provider.
The Consumer Financial Protection Bureau (CFPB) 2024 advisory opinion on medical debt says collecting amounts that aren't owed can break federal law. That includes bills that were already paid and services you didn't receive, such as "upcoded" charges for a more expensive service than the one you got.
What should a debt collector send me?
Under the federal debt collection rule, the CFPB says a debt collector must give you "validation information," usually in the first written notice or within five days of first contacting you. It must include:
- A statement that it's from a debt collector.
- The name of the creditor you owe.
- The account number, if there is one.
- An itemization of the current amount, showing interest, fees, payments, and credits since a certain date.
- The current amount of the debt.
- How to respond if you think the debt isn't yours or the amount is wrong.
- An end date for a 30-day period when you can dispute the debt.
Write that end date on your calendar.
How do I dispute a medical debt in collections?
The CFPB says that once you get the validation information, you have 30 days to dispute the debt in writing. If you dispute it in writing within that period, the collector must pause collecting the disputed amount until it responds with verification.
You can also ask, in writing within 30 days, for the name and address of the original creditor if it's different from the current one.
A short dispute letter might say:
I am writing about account number [number]. I dispute this debt because [reason: I don't recognize it / I believe Medicare and my supplement already paid / the amount is higher than my Medicare Summary Notice (MSN) shows]. Please send me verification of the debt, including an itemized statement from the original provider and the name and address of the original creditor.
The CFPB's debt collection page has a guide on how to reply to a debt collector. Send your letter by a method that shows it was delivered, and keep a copy.
How do I check whether I really owe the bill?
Go back to the source:
- Find the date of service and provider on the collection notice.
- Find your Medicare Summary Notice (MSN) or plan Explanation of Benefits for that date. Look at "Maximum You May Be Billed."
- Check whether your Medigap or other insurance paid its share.
- Ask the original provider for an itemized bill. The CFPB suggests asking the provider or the collector for an itemized bill to check for errors.
Common problems include a claim that was never sent to Medicare or your supplement, a charge above Medicare's limit, or a bill you already paid.
What if I'm in a Medicare Savings Program?
If you're in the Qualified Medicare Beneficiary (QMB) program, Medicare.gov says Medicare providers aren't allowed to bill you for Medicare-covered services and items, including deductibles, coinsurance, and copayments. You may owe a small Medicaid copayment. If a bill for covered care went to collections, tell the provider and the collector that you're in QMB and show your Medicaid or QMB card or your MSN. You can also call 1-800-MEDICARE for help.