Help Paying Medical Bills

A bill you can't pay is frightening, but it can be wrong and is often not final. Check it against what Medicare says you owe, and ask for an itemized bill. Then ask the hospital for its financial assistance form, also called charity care. If money is tight, you may owe less, or nothing. For free help, call your State Health Insurance Assistance Program (SHIP) at 1-877-839-2675.

You may qualify if

• You got care at a hospital and can't pay the bill.
• Your income is low or middle, and each hospital sets its own line. In California and New York, the law requires help up to $63,840 a year for one person in 2026.
• You have Medicare and still owe a lot. In both states, high costs can count even if you have insurance.

Not sure you qualify? Apply anyway, because the hospital makes the call and a nonprofit hospital must answer you in writing. If you would rather not do it alone, a Pair Team advocate can help you ask.

Where to start with a bill

How do I check a medical bill?

To check a medical bill, start with the paper from Medicare, not the bill. In Original Medicare, that's your Medicare Summary Notice, not a bill. Medicare mails it every 6 months if you had care. It shows the most you may owe each provider.

If the bill asks for more or lists care you didn't get, call the billing office and ask them to fix it. Then ask for an itemized bill in writing, which the office has 30 days to send. If Medicare said no to a claim, you have 120 days to appeal. See how to appeal a Medicare denial.

If you have QMB, you should not get these bills

With QMB, you do not owe Medicare copays or deductibles, in Original Medicare or Medicare Advantage. Call the billing office and say you're a Qualified Medicare Beneficiary. If the bills keep coming, call 1-800-MEDICARE (1-800-633-4227). To see if you can get QMB, read about Medicare Savings Programs.

Does the hospital have to help if I cannot pay?

A nonprofit hospital has to help. Under federal tax law, each one must have a written financial assistance policy. It covers emergency and other needed care. If you qualify, it cannot charge you more than it usually gets from patients with insurance.

It must tell you about its policy before it sues you, reports you to a credit bureau or sells your debt. It must also wait at least 120 days after the first bill you get once you leave the hospital. You get at least 240 days from that bill to apply. Other hospitals may have a policy too, so ask.

Can I set up a payment plan?

For a payment plan, call the billing office before the due date. Ask for a monthly amount you can afford. Ask if there's interest, and get the plan in writing. Apply for financial assistance before you sign the plan or use a credit card, so you pay the lower amount.

Does the No Surprises Act protect me on Medicare?

The No Surprises Act does not protect you if you only have Medicare. The Centers for Medicare & Medicaid Services (CMS) is the federal agency that runs Medicare. It says Medicare already protects you from some surprise bills. The law protects people with job, Marketplace or other individual plans, CMS says. If you also have a job plan, yours or a spouse's, the law may apply to it, so ask the plan.

In Original Medicare, these rules protect you:

• Doctors who take assignment can charge you only the Medicare deductible and coinsurance. In 2026, that's the $283 yearly deductible for doctor visits, then usually 20%.
• Doctors who don't take assignment can charge more, but usually no more than 15% above the Medicare-approved amount.

In a Medicare Advantage plan, if a bill is higher than your Explanation of Benefits shows, call the plan before you pay.

What a Pair Team advocate does

A big bill rarely comes alone. Often it follows a hospital stay, and rent and the power bill are due the same month. Here's what we do:

• Read the bill next to your Medicare notice, and call the billing office with you.
• Get the itemized bill and the financial assistance form, then fill it out with you and follow up.
• Check if you can get QMB or Medicaid, which can pay your copays from now on.
• Help with what usually comes with it: utility bills, food, Extra Help with prescriptions, and rides.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Can a hospital send me to collections while I apply for help?

A nonprofit hospital has to stop steps like lawsuits and credit reports while it looks at your full form. Send the whole form and keep a copy.

Will a medical bill hurt my credit?

A medical bill can hurt your credit. On July 11, 2025, a court struck down a federal rule keeping medical bills off credit reports. California and New York have their own bans, so check your state's rules below.

What does the 20% on my bill mean?

After your $283 deductible in 2026, Medicare usually pays 80% of the approved amount for doctor visits, and you pay 20%. A hospital stay starts with a $1,736 deductible for hospital insurance, and QMB pays these for you.

Can I get money back for a bill I already paid?

With QMB on the date of care, you can ask for your money back, because you never owed it. If a nonprofit hospital finds you qualify for help, it must refund what you paid over the new amount.

Who can I call for free help?

Your SHIP gives free Medicare counseling at 1-877-839-2675 or shiphelp.org. For questions about a claim, call 1-800-MEDICARE (1-800-633-4227).

Find the rules for your state

• California: free or lower-cost hospital care up to $63,840 a year for one person in 2026.
• New York: free hospital care under $31,920 a year for one person in 2026, discounts up to $63,840, and one state form.
• Nevada: the state's Bureau for Hospital Patients, at 1-888-333-1597, can help settle a fight over a hospital bill.

Everywhere else, ask the hospital for its policy, or call your SHIP at 1-877-839-2675.

Sources

• Medicare Summary Notice (MSN), Medicare.gov
• Social Security Act section 1806, Explanation of Medicare benefits, SSA
• Qualified Medicare Beneficiary (QMB) Program, CMS
• Financial assistance policy and emergency medical care policy, Section 501(r)(4), IRS
• Billing and collections, Section 501(r)(6), IRS
• Know your medical bill rights when using insurance, CMS
• Medical bill rights, CMS
• Does your provider accept Medicare as full payment?, Medicare.gov
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• Prohibition on Creditors and Consumer Reporting Agencies Concerning Medical Information (Regulation V), CFPB
• Hospital financial assistance, New York Attorney General
• Hospital Bill Complaint Program, HCAI
• State Health Insurance Assistance Programs