Medical Debt Rights in Maryland
Reviewed by the Commoner Law Editorial Team. Sourced from primary statutes (U.S. Code, CFR, state compiled statutes) and official government agency guidance. Written in plain language for general understanding — this is educational content, not legal advice. Our editorial standards
What is this right?
Medical debt is the leading cause of bankruptcy in the United States, affecting an estimated 100 million Americans. Recent federal actions have significantly strengthened your rights when dealing with medical debt — including new rules removing most medical debt from credit reports and protections against surprise billing.
The No Surprises Act (effective January 2022) protects you from unexpected bills when you receive emergency care or are treated by an out-of-network provider at an in-network facility without your consent. Additionally, the three major credit bureaus voluntarily removed medical debt under $500 from credit reports in 2023, and the CFPB finalized a rule in January 2025 to remove all medical debt from credit reports, but a federal court vacated that rule in July 2025 (Cornerstone Credit Union League v. CFPB) before it took effect.
When does it apply?
Your medical debt rights apply when:
- You received a medical bill you cannot afford or believe is incorrect
- You received emergency care at an out-of-network hospital or from an out-of-network provider at an in-network facility
- A medical debt collector is contacting you about a bill
- Medical debt appears on your credit report
- You are being sued for medical debt
Key protections:
- No Surprises Act: You cannot be balance-billed for emergency services, air ambulance from out-of-network providers, or non-emergency care from out-of-network providers at in-network facilities (unless you gave written consent). You pay only your in-network cost-sharing amount.
- Nonprofit hospital requirements: Under IRS § 501(r), tax-exempt hospitals must have a written financial assistance policy, publicize it, and screen patients for assistance before pursuing collections. Many patients qualify for free or reduced-cost care but are never told.
- Credit reporting changes: As of 2023, paid medical debt is removed from credit reports, and unpaid medical debt under $500 does not appear. A CFPB rule that would have removed all medical debt from credit reports was vacated by a federal court in July 2025 before it took effect.
- Good faith estimate: Under the No Surprises Act, uninsured patients can request a Good Faith Estimate before scheduled care. If the final bill exceeds the estimate by $400 or more, you can dispute it.
Common misconceptions:
- "I have to pay whatever the hospital charges" — Hospital "chargemaster" prices are often wildly inflated. You have the right to request an itemized bill, dispute errors, and negotiate the amount.
- "Medical debt will ruin my credit forever" — Medical debt under $500 no longer appears on credit reports, and all paid medical debt is removed. The trend is toward removing medical debt from credit entirely.
- "Nonprofit hospitals don't have to help me" — Tax-exempt hospitals are legally required to have financial assistance programs. Many patients qualify for charity care that covers 50-100% of their bill.
What to Do If You Get a Medical Bill You Can't Afford
Step 1: Request an itemized bill. Medical billing errors are extremely common — studies suggest up to 80% of medical bills contain errors. Compare the itemized bill against your insurance Explanation of Benefits (EOB).
Step 2: If you received a surprise bill (out-of-network charges you didn't consent to), file a complaint under the No Surprises Act. Contact your insurer, the provider, and CMS at 1-800-985-3059. You should only owe your in-network cost-sharing amount.
Step 3: Ask the hospital about financial assistance. If the hospital is a nonprofit (most are), they must have a financial assistance policy. Request the application — you may qualify for free or reduced-cost care even with insurance.
Step 4: Negotiate the bill. Hospitals regularly accept less than the full amount. Ask for a reduction, a payment plan with no interest, or offer a lump-sum settlement for a lower amount. Get any agreement in writing.
Step 5: If the debt goes to collections, know your FDCPA rights. Request debt validation in writing within 30 days. Medical debt collectors must follow the same rules as any other debt collector. If the debt is on your credit report, check whether it qualifies for removal under the new credit reporting rules.
What should you NOT do?
Don't pay a bill you haven't verified. Always request an itemized bill and compare it to your insurance EOB before paying. Errors are extremely common.
Don't put medical debt on a credit card. Medical debt has special protections (lower interest, financial assistance eligibility, credit reporting limits) that you lose once you transfer it to a credit card.
Don't ignore the bill entirely. While medical debt protections are expanding, ignoring bills can lead to lawsuits, wage garnishment, and damage to your credit that could have been avoided through negotiation or financial assistance.
Don't assume you don't qualify for financial assistance. Income thresholds for hospital charity care programs are often surprisingly high (200-400% of the federal poverty level). Apply even if you think your income is too high.
How Maryland differs from federal law
Maryland provides meaningful protections for residents dealing with medical debt:
- Short statute of limitations: Maryland's statute of limitations on most consumer debt, including medical debt, is 3 years (MD Code, Courts & Judicial Proceedings § 5-101) — one of the shortest in the country
- Hospital financial assistance: Maryland requires hospitals to have financial assistance policies and to screen patients for eligibility before pursuing collections. The Health Services Cost Review Commission (HSCRC) regulates hospital rates
- Unique rate-setting system: Maryland is the only state with an all-payer hospital rate-setting system through the HSCRC, which sets uniform rates for all payers including uninsured patients — preventing the extreme price disparities seen in other states
- Wage garnishment limits: Maryland limits wage garnishment to the lesser of 25% of disposable earnings or the amount by which weekly earnings exceed 30 times the federal minimum wage (MD Code, Commercial Law § 15-601.1)
- Maryland Medical Debt Protection Act: Provides additional protections against aggressive medical debt collection, including limits on interest rates and requirements for debt collectors
Additional Steps in Maryland
Ask the hospital about financial assistance programs before paying. Request an itemized bill and check for errors. File collection complaints with the Maryland AG at (410) 528-8662. Contact Maryland Legal Aid at (410) 539-5340 for free legal help. The HSCRC can be reached at (410) 764-2605.
Relevant Law: MD Code, Courts & Judicial Proceedings § 5-101 (3-year statute of limitations). MD Code, Health-General § 19-214.1 (hospital financial assistance). MD Code, Commercial Law § 15-601.1 (wage garnishment limits).
Common Questions
When does medical debt rights apply?
Your medical debt rights apply when:You received a medical bill you cannot afford or believe is incorrectYou received emergency care at an out-of-network hospital or from an out-of-network provider at an in-network facilityA medical debt collector is contacting you about a billMedical debt appears on your credit reportYou are being sued for medical debtKey protections:No Surprises Act: You cannot be balance-billed for emergency services, air ambulance from out-of-network providers, or non-emergency care from out-of-network providers at in-network facilities (unless you gave written consent). Y...
What should I do if I receive a medical bill I can't afford to pay?
Step 1: Request an itemized bill. Medical billing errors are extremely common — studies suggest up to 80% of medical bills contain errors. Compare the itemized bill against your insurance Explanation of Benefits (EOB).Step 2: If you received a surprise bill (out-of-network charges you didn't consent to), file a complaint under the No Surprises Act. Contact your insurer, the provider, and CMS at 1-800-985-3059. You should only owe your in-network cost-sharing amount.Step 3: Ask the hospital about financial assistance. If the hospital is a nonprofit (most are), they must have a financial assista...
What mistakes should I avoid with medical debt rights?
Don't pay a bill you haven't verified. Always request an itemized bill and compare it to your insurance EOB before paying. Errors are extremely common.Don't put medical debt on a credit card. Medical debt has special protections (lower interest, financial assistance eligibility, credit reporting limits) that you lose once you transfer it to a credit card.Don't ignore the bill entirely. While medical debt protections are expanding, ignoring bills can lead to lawsuits, wage garnishment, and damage to your credit that could have been avoided through negotiation or financial assistance.Don't assum...
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