Does medical debt affect your credit score anymore?

The emergency room (ER) bill showed up months ago, and now a collection agency is calling. You've heard medical debt doesn't count against your credit anymore, so maybe you've let it sit.

So does medical debt affect your credit score? It can, but far less often than it used to. Three credit bureau policies decide it for most people, and none of them is a law.

The short answer: Sometimes. Equifax, Experian and TransUnion keep an unpaid medical bill off your credit report until it's been delinquent for a year, don't report medical collections under $500, and remove them once they're paid, according to Experian. An unpaid medical collection of $500 or more that's over a year past due can still appear and lower your score for up to seven years.

Key takeaways

• A medical bill reaches your credit report only once it's in collections, started at $500 or more and is more than a year past due.
• Newer scores, such as FICO Score 9 and newer VantageScore models, count unpaid medical collections less or not at all, but many lenders use older versions.
• The federal rule that would have removed medical debt from credit reports was vacated on July 11, 2025, so the bureaus' policies are voluntary.
• Colorado and New York restrict medical debt reporting; Pennsylvania's proposed ban has been in committee since March 6, 2025.
• Before you pay a large medical collection, check your reports, make sure the bill is right and ask about financial assistance.

When does medical debt affect your credit score?

Under the bureaus' current policies, medical debt affects your credit score only when an unpaid bill has gone to collections, started at $500 or more, and stayed delinquent for over a year. The three major credit bureaus adopted those rules on their own, in two steps:

• July 1, 2022. Paid medical collections came off credit reports. Unpaid ones stopped appearing for up to one year, "an increase from 180 days," according to the Consumer Financial Protection Bureau (CFPB) in its 2025 medical debt rule.
• April 2023. The bureaus removed medical collections "with initial balances below $500."

Equifax and Experian both still describe these policies on their own pages.

What still gets through

The policies shrank medical debt on credit reports without erasing it. Even after the changes, the CFPB found that "15 million Americans still have $49 billion in medical bills on their consumer reports," based on data through June 2023. The bureaus removed the small balances, so the big bills are the ones still there.

A reported medical collection can stay a long time. The Fair Credit Reporting Act (FCRA) allows collection accounts on your report for seven years, and the clock starts 180 days after the delinquency began (15 U.S.C. 1681c). By KAV's math, that's up to about seven and a half years from the day you first fell behind.

A quick example: one ER bill

Take Andre, 38, a warehouse supervisor in Ohio. He's an example, not a client.

• The bill: $1,800 after an ER visit, delinquent as of March 1, 2026.
• Earliest it can appear: March 2027, after the bureaus' one-year grace period.
• If he pays before then: it never shows up.
• If it's reported and he pays later: it comes off his report.
• If he never pays: the FCRA lets it stay until about late August 2033.

Had the same bill been $450, it would never appear on his report at all, paid or not.

How much can a medical collection hurt your credit score?

How much a medical collection hurts depends on which credit score the lender pulls, because newer scoring models count medical collections less or ignore them. You usually don't get to choose, so know the main ones:

• FICO Score 9. "Unpaid medical collections will have less of a negative impact on FICO® Score 9," and paid collections, medical ones included, no longer count against you, according to myFICO.
• FICO Score 8. myFICO calls it "the most widely used version," and it came before the FICO 9 change.
• Mortgage scores. For mortgages, lenders typically use FICO Score 5, 4 or 2, one for each bureau, per myFICO. Those are older versions too.
• VantageScore. VantageScore removed all medical collections from its model in 2022, the CFPB noted, and Experian says newer VantageScore models "don't consider unpaid medical collections at all."

There's no single number for the damage. VantageScore said "millions of consumers may see an increase of up to 20 points" when it dropped medical collections. The CFPB also found that people whose medical collections were all under $500 before the 2023 change saw their scores rise 20 points more than people with at least one larger collection.

If your score sits close to a lender's cutoff, a change that size can matter. Our guide to what a good credit score is shows where the common cutoffs sit.

What happened to the federal medical debt rule?

The federal rule that would have removed medical debt from credit reports never took effect: a federal court in Texas vacated it on July 11, 2025. Here's the timeline, from the CFPB's page for the rule:

1. January 7, 2025. The CFPB issued a final rule that, in Experian's words, "would have removed all medical debt from credit reports used by lenders."
2. March 17, 2025. The rule's effective date, later stayed until June 15, 2025.
3. July 11, 2025. The U.S. District Court for the Eastern District of Texas vacated the rule in Cornerstone Credit Union League v. CFPB. The CFPB and the plaintiffs asked for it jointly, and the court agreed "the rule exceeded the Bureau's statutory authority."

So is medical debt back on credit reports? Not the small or paid bills. The bureaus' 2022 and 2023 policies were never part of the rule, and they still apply. They're voluntary, though. The CFPB wrote that "their voluntary nature means there is some uncertainty about whether the changes could be reversed in the future," so check your reports rather than assume.

Does your state keep medical debt off credit reports?

Some states go further than the bureaus, but each law works differently, and the CFPB now says federal law overrides them. A few examples:

• Colorado. Since August 7, 2023, a credit bureau can't put adverse information in a consumer report if it "knows or should know concerns medical debt" (House Bill 23-1126). Loans above the national conforming loan limit are an exception, and the rule is scheduled to expire on July 1, 2028.
• New York. The Fair Medical Debt Reporting Act, signed December 13, 2023, "prohibits hospitals, health care professionals and ambulances from reporting" medical debt to credit agencies, according to the governor's office.
• Pennsylvania. No ban has passed. Senate Bill 371 would bar medical creditors from reporting patients to credit agencies and require screening for Medicaid and financial assistance first. It went to the Health and Human Services Committee on March 6, 2025, and hadn't been reported out as of November 10, 2026.

The federal pushback

On October 28, 2025, the CFPB published an interpretive rule saying the FCRA "generally preempts State laws that touch on broad areas of credit reporting." It also rejected an earlier CFPB view that states can regulate whether medical debt appears on a credit report.

The same document says it "has no legally binding effect" and that parties "can litigate such questions in court." State laws stay on the books until a court says otherwise. Your state attorney general's consumer protection office can tell you how yours is being applied.

What to do about a medical bill in collections

Start by finding out whether the bill is on your report and whether it's even right, then ask for help before you pay:

1. Pull all three credit reports. You can view them online for free once a week at AnnualCreditReport.com, the site the CFPB points to. Look for accounts marked medical or collection.
2. Make sure the bill is yours and it's correct. Ask the provider for an itemized bill and compare it with your health plan's explanation of benefits. Bills for care you didn't get, or already paid for, do happen.
3. Dispute errors with both sides. "Fixing an error generally means contacting both the credit reporting company and the company that provided the information," the CFPB says. The company that reported it generally must respond within 30 days. Send proof of payment, such as a receipt from your health savings account (HSA).
4. Ask a nonprofit hospital for financial assistance. Under Section 501(r)(6), a tax-exempt hospital must make "reasonable efforts" to see whether you qualify for its financial assistance before extraordinary collection actions, and reporting you to a credit bureau is one. It generally has to wait at least 120 days from the first bill after discharge, and you get a 240-day window to apply, per the Internal Revenue Service.
5. Pay it, if it's accurate and you can. A paid medical collection comes off your report, which "can have an immediate positive impact on your credit score," Experian says. Keep the payment confirmation.

Where to start this week

1. List every medical bill you owe: who sent it, the balance and the date it first came due.
2. Mark the ones that are $500 or more and nearly a year past due. Those can reach your report.
3. Call those billing offices first and ask for an itemized bill and a financial assistance application.
4. Set up an automatic transfer, even a small one, toward an emergency fund for the next bill.
5. Put a reminder on your calendar to check your credit reports again in a month.

If you would like help turning this into a plan, KAV Solutions offers a complimentary Financial Needs Analysis. A licensed insurance professional walks through your cash flow, emergency savings and the coverage that protects your family's income if an illness keeps you out of work. The analysis is free and you never pay KAV a fee. If you choose to buy a policy, the insurer pays the professional a commission.

KAV's professionals aren't attorneys. For a dispute with a collector or a question about your state's law, contact your state attorney general's office.

Frequently asked questions

KAV Solutions is a women-led team of licensed insurance professionals based in Pennsylvania. This article is general education, not individualized financial, tax, or legal advice. Credit reporting policies and state laws change and vary by state, so check the rules where you live.