Medical Debt Rights in Massachusetts
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 Massachusetts differs from federal law
Massachusetts has strong medical debt protections, largely due to its near-universal healthcare system:
- MassHealth (Medicaid) is one of the most expansive programs in the US, covering residents up to 138% of the federal poverty level with broad eligibility categories
- The Health Safety Net program covers uninsured and underinsured MA residents for medically necessary services at acute care hospitals and community health centers
- The MA Health Connector marketplace provides subsidized insurance plans, with many residents qualifying for ConnectorCare plans with very low premiums and copays
- Statute of limitations on medical debt in MA is 6 years (contract actions under MGL c. 260, § 2)
- MA Community Benefits requirements obligate nonprofit hospitals to provide financial assistance and charity care
- Hospitals must screen patients for MassHealth and Health Safety Net eligibility before pursuing collections
- Medical debt collection is subject to the MA AG's Debt Collection Regulations (940 CMR 7.00) with potential treble damages under 93A
Additional Steps in Massachusetts
Apply for MassHealth at mass.gov/masshealthapply or call 1-800-841-2900. Enroll through the MA Health Connector at mahealthconnector.org. Request financial assistance from your hospital's billing department. File medical debt complaints with the MA AG at (617) 727-8400.
Relevant Law: MGL c. 118E (MassHealth). MGL c. 176Q (Health Connector). MGL c. 260, § 2 (statute of limitations). 940 CMR 7.00 (Debt Collection Regulations).
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...
Legal Resources
We may earn a commission if you use these services — at no extra cost to you. This supports our mission to make legal information free for everyone.