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Medical debt remains a major challenge for many Americans, often leading to stress and financial strain. But can debt collectors legally add interest on top of what you already owe? The answer isn’t always simple—it depends on factors such as the original medical agreement, state regulations, and federal laws.

Many assume that once a bill is sent to collections, debt collectors have unrestricted authority to add fees and interest. However, this is not always the case. Whether or not your debt accrues additional charges is determined by legal agreements, state-specific rules, and court decisions. Unfortunately, many consumers are unaware of their rights when it comes to disputing unfair charges.

Knowing when medical debt can accrue interest, understanding legal protections, and learning how to challenge unlawful charges can help you take control of the situation. Let’s explore the key details.

When Can Debt Collectors Charge Interest on Medical Bills?

Debt collectors cannot arbitrarily add interest to your medical bills. They can only do so under specific conditions. Here’s when interest charges may apply:

1. The Original Medical Agreement Allows It

If your healthcare provider included interest terms in your original financial agreement, then a debt collector may have the legal right to enforce them. However, if there was no mention of interest, adding it later could violate the Fair Debt Collection Practices Act (FDCPA). Always check the fine print on any medical billing agreements you’ve signed.

2. State Laws Permit It

Medical debt collection laws vary by state. Some states strictly prohibit interest charges on medical debt, while others allow collectors to charge a capped amount. For example:

  • California bans hospitals from charging interest if the patient is on a payment plan.
  • Maryland does not allow interest to accrue on medical debt until a court judgment is issued.
  • Illinois allows up to 5% pre-judgment interest, increasing to 9% post-judgment.
  • Arizona caps interest rates on medical debt to prevent excessive charges.
  • Connecticut prohibits charging interest to patients below 250% of the federal poverty level who are ineligible for public insurance programs.
  • Delaware and Maine prohibit creditors from charging interest on medical debt.
  • New Jersey and New York establish caps on interest rates for medical debt.

3. A Court Judgment Has Been Issued

If a creditor sues you for unpaid medical debt and wins, the court may grant permission to add interest. In this case, the debt collector is legally allowed to apply interest charges, often at the rate determined by state law.

Understanding the legal framework is essential, but how often do Americans actually face medical debt in collections? Let’s take a look at the latest statistics to get a clearer picture.

Tip: Always request a debt validation letter from the collector. This document provides written proof of the debt, the total amount owed, and whether any interest has been legally applied.

How Common Is Medical Debt in Collections in 2024? 

Medical debt remains a significant financial burden in the United States. Recent statistics reveal:

  • Prevalence of Medical Debt: Approximately 20 million U.S. adults (nearly 1 in 12) have medical debt, totaling at least $220 billion nationwide. 
  • Debt Amounts: About 14 million people (6% of adults) owe over $1,000 in medical debt, while 3 million (1% of adults) owe more than $10,000. 
  • Geographic Disparities: Southern states exhibit higher medical debt rates, with South Dakota at 17.7%, Mississippi at 15.2%, and North Carolina at 13.4%. 
  • Rural vs. Urban Divide: 15.7% of rural residents have medical debt in collections, compared to 14.8% in urban areas, with the median debt being $62 higher in rural regions. 

These statistics underscore the widespread impact of medical debt across various demographics and regions in the U.S.

With millions struggling to pay off medical expenses, even a small added interest charge can push debt further out of reach. Let’s explore how these charges impact financial stability.

The Financial Impact of Medical Debt Interest

Interest on medical debt doesn’t just increase the amount owed—it also has wider financial consequences:

  • Budget strain: Many individuals cut back on necessities like food, rent, and utilities just to keep up with medical debt payments.
  • Savings depletion: Families often dip into emergency funds or retirement accounts or take on high-interest credit card debt to cover medical expenses.
  • Credit damage: 35% of people with medical debt in collections report a significant negative impact on their credit scores.

Given these challenges, reducing or eliminating interest on medical debt can help ease financial stress. One major factor influencing medical debt levels is Medicaid expansion.

Check out this video by NBC10 Boston to understand how medical debt affects credit and finances.

How Medicaid Expansion Affects Medical Debt?

One of the biggest determinants of medical debt levels in a given state is whether it has expanded Medicaid under the Affordable Care Act (ACA). Research shows that:

  • Medicaid expansion states saw a 34% greater decline in medical debt compared to non-expansion states.
  • As of 2024, 40 states (including Washington, D.C.) have expanded Medicaid, while 10 states have not.
  • States that haven’t expanded Medicaid tend to have higher medical debt rates.

If you live in a non-expansion state, medical expenses are more likely to become unpaid debt and end up in collections—potentially accruing interest. Understanding your rights can help you fight back against unfair charges.

What to Do If a Collector Charges Interest on Medical Debt?

If you discover unexpected interest charges on your medical debt, take the following steps:

1. Request a Debt Validation Letter

Debt collectors must provide written proof of the debt and any added charges. If the interest wasn’t part of the original agreement, they may not legally enforce it.

2. Check Your State Laws

Find out if your state caps or prohibits interest on medical debt. If the collector is violating these laws, you have grounds to dispute the charges.

3. Negotiate Directly with the Healthcare Provider

Hospitals and clinics often have financial assistance programs that can reduce or eliminate interest. Ask if you qualify for:

  • Hardship-based interest waivers
  • Income-based repayment plans
  • Medical debt forgiveness programs

4. Know Your Rights Under the FDCPA

The Fair Debt Collection Practices Act (FDCPA) protects consumers from unfair collection practices, including unauthorized interest charges. If you believe your rights have been violated, you can file a complaint with the Consumer Financial Protection Bureau (CFPB).

5.  Dispute Unlawful Interest Charges

If you believe you’re being unfairly charged interest, take action:

  • File a complaint with the CFPB or your state’s attorney general office.
  • Seek legal assistance to challenge unauthorized charges.
  • Report the collector to the Federal Trade Commission (FTC) if they’re violating consumer protection laws.

If you’re overwhelmed by medical debt collections and negotiations, seeking expert guidance can make a difference.

Real-Life Experiences: Consumers Facing Interest on Medical Debt

Many consumers have shared their frustrations with unexpected interest charges on medical debt that had been sent to collections. Their experiences highlight how easily debt collection practices can become confusing, misleading, or even unlawful.

  • Medical Debt in Collections – One Reddit user was shocked to discover steep interest charges added after their medical bill was transferred to collections. During the discussion, others pointed out a crucial but often-overlooked detail—setting up a payment plan can reset the statute of limitations, allowing collectors to continue charging interest for an extended period. This highlights the importance of understanding how payment agreements affect your rights and being cautious when negotiating repayment terms.

This real-life case underscores why knowing your rights, verifying debt details, and challenging unlawful interest charges is essential. If you’ve received a medical debt notice with unexpected interest, review the original agreement, check state laws, and demand proper documentation from the collector before making any payments.

Suppose you’re struggling with medical debt collections or need professional guidance on how to navigate disputed charges. In that case, Shepherd Outsourcing Collections provides expert solutions to help individuals and businesses manage outstanding debts with transparency and professionalism. 

Once medical debt reaches a third-party debt collector, it often comes with additional collection fees or interest charges, which can further compound financial struggles. Understanding how debt collectors apply interest compared to original medical providers is key to avoiding unnecessary financial strain.

Government Efforts to Reduce Medical Debt

To combat the rising costs of medical debt, some state and federal programs aim to protect consumers from aggressive collection tactics, including excessive interest charges:

  • New Jersey allocated $10 million to medical debt relief programs for low-income residents.
  • Cook County, Illinois, used federal funding to eliminate $1 billion in medical debt.
  • 51% of Americans believe the government should take a more active role in reducing medical debt.

With growing public awareness and policy shifts, consumers may soon see better protections against interest charges on medical debt.

Also read: Do Debt Collectors Charge Interest on Outstanding Debts?

Conclusion

What would you do if you found out a debt collector was illegally charging interest on your medical debt? Many people assume these charges are unavoidable, but that’s not always the case. Understanding your rights regarding medical debt is crucial in protecting yourself from unfair practices. While debt collectors can charge interest on medical debt in certain situations, it must be legally permitted—either by your original agreement, state laws, or a court judgment. If you notice added interest on your bill, always verify its legality, dispute unauthorized charges, and explore financial assistance options to minimize your burden.

Dealing with medical debt can be overwhelming, but you don’t have to face it alone. Whether you need help understanding your rights, negotiating settlements, or handling collections, Shepherd Outsourcing Collections provides professional, transparent solutions. Don’t let medical debt control your financial future—reach out today for expert assistance in managing and resolving your outstanding debts.

FAQs

  1. Can medical debt expire or be forgiven?

Yes, medical debt is subject to a statute of limitations, which varies by state. Once this period expires, collectors cannot sue you for payment, though the debt may still exist. Some hospitals and nonprofit programs also offer medical debt forgiveness for qualifying individuals.

  1. Will paying a medical bill in collections remove it from my credit report?

Not necessarily. Paid medical debt can still remain on your credit report for up to seven years, depending on the scoring model used. However, newer credit scoring models (like FICO 9 and VantageScore 4.0) give less weight to paid medical collections, meaning they may have less impact on your score.

  1. Can medical debt affect my ability to get a mortgage?

Yes, unpaid medical debt in collections can impact your debt-to-income ratio (DTI) and lower your credit score, potentially affecting your mortgage approval. However, if your medical debt is under $500, it will no longer appear on credit reports from major bureaus due to recent policy changes.

  1. Do medical providers have to notify me before sending my debt to collections?

In most cases, yes. Many hospitals and clinics must make a reasonable effort to contact you before turning your bill over to collections. Under the No Surprises Act, certain types of medical debt require clear, upfront billing transparency, and some states require providers to offer payment plans before collections.

  1. Can a hospital refuse treatment if I have unpaid medical debt?

Generally, emergency rooms cannot deny care due to unpaid debt, as federal law (EMTALA) requires them to stabilize patients regardless of financial status. However, non-emergency services may be restricted by some providers if you have outstanding balances, depending on the hospital's policy.