How to set up a medical bills payment plan

Many hospitals and offices offer payment plans

Many hospitals and offices will let a patient pay a bill in smaller pieces over time. A payment plan is an agreement to pay a set amount each month until the bill is paid. It is not a loan from a bank, and with the right office it may not cost any extra.

Offices do not all have the same rules. Some have a plan ready for anyone who asks, and others only offer one after a supervisor steps in. Interest is charged by some offices and not by others. The billing office will not always bring a plan up, so you have to ask for it.

A plan works best when it is set up before the bill goes to collections. If your bill is already there, read our guide on medical bills in collections first.

Ask for help with the bill before you ask for a plan

A payment plan spreads the bill out, but it does not make the bill smaller. It is smart to try to lower the bill first, so that a plan only has to cover what is left.

Start by asking for an itemized bill, which lists each charge, and check it for mistakes. Then ask whether there is a financial assistance program. The IRS requires nonprofit hospitals to have a written financial assistance policy. A hospital can lower or erase a bill for a person who qualifies. Our guide on hospital financial assistance shows how to apply.

After that, ask about a discount for people who pay on their own. Phone scripts for every step are in our guide on how to negotiate a medical bill.

How to ask the provider for an interest-free plan

Call the billing office and not the front desk. Be calm and honest about what you can pay, because a plan you can keep is safer than a bigger one you will miss.

• "Do you offer a payment plan with no interest?"
• "What is the lowest monthly payment you can accept?"
• "Are there any set-up fees, or fees if I pay late?"
• "Will the account stay out of collections as long as I pay on time?"
• "Can you send me the full terms in writing before I agree?"

If the first person says no, ask whether a supervisor can look at it. It also helps to ask how long the plan would last and whether you can pay it off early without a penalty. Offer a monthly amount that fits your budget, and say the number plainly.

Keep a note of the date, the person's name and what was agreed. A promise made on the phone is not enough to rely on, so wait for the written terms before you make the first payment.

Be careful with medical credit cards and loans

Some offices offer a medical credit card or a medical loan at the front desk. These are products from outside lenders that are made for health costs, and they can be easy to sign up for. Their cost may be far higher than the cost of a plan from the office.

The Consumer Financial Protection Bureau, a federal agency that protects people who use banks and lenders, studied these products in a 2023 report. It said medical credit cards could carry an interest rate of 26.99 percent and medical loans a rate of 16 percent. The agency said these rates were much higher than traditional credit cards.

The same report looked closely at deferred interest, which is a deal that says no interest for a set time. A person who has not paid the whole balance by the end owes all the interest from the first day. The agency found that people paid about $1 billion in deferred interest on these products from 2018 to 2020.

The report also says patients are often offered these products even when insurance might cover the care or when they might qualify for financial assistance. Before you sign, ask if the office has its own plan with zero interest. Read the terms, and check what happens if you miss a payment.

If you cannot afford even a small payment

Tell the office the truth about your income and costs. Ask whether it has a hardship program, which is help for people whose money is very tight. You can also ask to pause the bill for a short time while you apply for financial assistance.

The number 2-1-1 is a confidential phone service that connects people with local help. A call there can point you to groups near you that help with medical costs. Our medical bill help guide shows where to start and lists more places to look for help.

Keep your plan on track

1. Pay on the same day each month, or set up an automatic payment only if you are sure the money will be there.
2. Keep every receipt and every letter about the plan.
3. If money gets tight, call the office before you miss a payment and ask to change the amount.
4. When you finish, ask for a letter that says the account is paid in full.

Your credit can be hurt if a bill goes to collections. The three big credit bureaus wait a year before they list an unpaid medical collection. More details are in our guide on medical bills and your credit report.

If you think you are having an emergency, call 911 or go to the nearest emergency room right away. Do not let a bill stop you from getting care. For regular care at a price you can plan for, you can search our directory of cash-pay doctors. This page is general education and is not financial or legal advice.