When does medical debt appear on your credit report?

Most medical debt no longer shows up on credit reports. Since 2022 and 2023, Equifax, Experian and TransUnion leave out paid medical collections, medical collections that started under $500, and unpaid ones until they are at least a year past due. Those are voluntary policies of the three bureaus, not federal law: the CFPB rule that would have removed medical debt from reports altogether was vacated by a federal court in July 2025. A larger unpaid medical bill that sits in collections for more than a year can still be reported and still hurt your score.

What the three bureaus stopped reporting

• Paid medical collections, since July 1, 2022. Once a medical collection is paid, it is deleted, not just marked paid.
• Unpaid medical collections less than a year old, since July 2022. The waiting period went from 180 days to one year. In its 2024 description of these changes, the CFPB said medical collections must be at least one year past the date of first delinquency before they appear.
• Medical collections with an initial balance under $500, since April 11, 2023. The bureaus said that change removed nearly 70% of medical collection accounts from credit files.

Before these changes, a paid medical collection could stay for seven years. Scoring models had already started moving: VantageScore 3.0 and 4.0 ignore medical collections entirely, and FICO Score 9 gives unpaid medical collections less weight than other collections. FICO Score 8, still widely used, treats them like any other collection.

The pressure came from research. The CFPB’s March 2022 report on medical debt found that medical collections on credit reports said little about whether someone would repay other credit, and described how billing errors and insurance disputes routinely leave people unsure what they owe.

Where federal rules stand now

In January 2025 the CFPB finalized a rule that would have kept medical bills off credit reports used by lenders. Industry groups sued, the CFPB under new leadership joined them in asking the court to vacate it, and on July 11, 2025 the U.S. District Court for the Eastern District of Texas did, finding the rule exceeded the CFPB’s authority. The rule never took effect.

In October 2025 the CFPB went further and issued an interpretive rule stating that the Fair Credit Reporting Act preempts state laws that restrict what credit reports may contain, including medical debt. Interpretive rules don’t bind courts, but they signal how the agency reads the law.

State laws, and why they are in question

More than a dozen states have passed their own limits. Colorado’s 2023 law (HB 23-1126) bars adverse medical debt information from credit reports, and California’s SB 1061, in effect since January 1, 2025, bars reporting medical debt to credit bureaus and makes a medical debt unenforceable if it is knowingly reported.

Those protections are now contested. In November 2025, ACA International, a collection-industry trade group, sued to block Colorado’s law, arguing that federal law preempts it, and it cited the CFPB’s interpretive rule. Until courts settle the question, a state ban is a real protection that could be narrowed. Your state attorney general’s office can tell you what applies where you live.

What these rules don’t cover

The bureau policies apply to medical collection accounts: debts that a hospital, doctor or lab sent to a collection agency. They do not cover:

• A medical bill you paid with a regular credit card. Once it is on the card, it is card debt, and a missed card payment is reported like any other.
• Medical credit cards and patient financing loans. Late payments on those are reported under the usual rules.
• Unpaid medical collections of $500 or more that are over a year past due. Those can appear and can stay for seven years, starting 180 days after the original delinquency.

That first point matters more than it looks. Putting a disputed or unaffordable hospital bill on a credit card converts a debt with special protections into one with none, plus interest.

What to do when a medical bill arrives

1. Match the bill to your insurer’s explanation of benefits. Ask the provider for an itemized bill and question any charge your plan shows as denied or still processing. Insurance appeals take time, which is exactly what the one-year window is for.
2. Ask about financial assistance, early. Nonprofit hospitals must have a written financial assistance policy under section 501(r) of the tax code. They may not take “extraordinary collection actions,” which include reporting you to a credit bureau or selling the debt, until at least 120 days after the first post-discharge bill, and you have at least 240 days from that bill to apply.
3. Set up a payment plan directly with the provider, in writing. A provider’s interest-free plan usually costs less than any loan or card you could use instead.
4. If a collector contacts you, ask for the validation notice and dispute in writing within its deadline if the amount is wrong. Our guide to dealing with a debt collector has a sample letter.

Check your reports and dispute errors

You can pull free reports from all three bureaus at AnnualCreditReport.com; federal law guarantees one a year from each, and the bureaus have made weekly free reports permanent. Look for three things: a paid medical collection, a medical collection that started under $500, and a medical collection that appeared less than a year after the bill went unpaid. Under the bureaus’ own policies, none of those should be there.

Dispute any you find with the bureau that shows it, and attach proof such as a payment receipt. The bureau generally has 30 days to investigate. The CFPB explains how to file a dispute, and our guide to disputing a credit report error walks through the letter and the follow-up.