Fighting Medical Debt in Virginia
I got a medical bill I can't afford — here's what Virginia law says and what to do next.
Statute: Va. Code § 38.2-3445.01 (Virginia Balance Billing Protections — SB 1441)
Deadline: 120 days
Penalty: Virginia restricts surprise billing and medical debt credit reporting. Violations may result in penalties from the Virginia Bureau of Insurance
What is fighting medical debt?
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.
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.
How Virginia differs from federal law
Virginia has limited specific medical debt protections, though Medicaid expansion has reduced medical debt burdens:
- Virginia expanded Medicaid in 2019, extending coverage to approximately 500,000 additional low-income adults and reducing uncompensated medical debt
- The statute of limitations for medical debt in Virginia is 5 years for written contracts (Va. Code § 8.01-246)
- Virginia limits wage garnishment for debt to 25% of disposable earnings or the amount exceeding 30 times the federal minimum wage, whichever is less
- Virginia hospitals and health systems are generally required to provide financial assistance information to patients
- Federal protections apply: medical debt under $500 is excluded from credit reports, and paid medical debt must be removed from credit reports
- Virginia allows homestead and personal property exemptions to protect some assets from medical debt collection
Additional steps in Virginia
Request an itemized bill and review it for errors. Ask the hospital or provider about financial assistance programs and charity care. Contact Legal Aid of Virginia at (866) 534-5243 for help with medical debt issues. File complaints about debt collectors with the Virginia Attorney General at (800) 552-9963.
What you should 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.
You shouldn't have to hire a lawyer to assert your rights.
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Generate your medical bill dispute →This page is general legal information for Virginia, not legal advice for your specific situation. Laws change, and how a statute applies depends on facts we don't know. For advice on your matter, consult a licensed attorney in Virginia.