The short answer
If you don’t pay a medical bill in New York, the first months bring more bills, letters and phone calls, and nothing else. After 180 days a hospital may hand the account to a collection agency. It may not put the debt on your credit report, may not take your wages or your home, and in most cases may not sue you at all.
None of that makes the debt disappear. It means you have time, and in New York time is valuable, because the same hospital that sends the bill is required by law to reduce it for most households. The worst outcomes come from two moves: ignoring court papers and paying the bill with a credit card.
The timeline
- Day 0 The first bill after you leave the hospitalThe 180-day clock starts here. Statements before this are often summaries; ask for the itemized bill.
- Days 1–30 Your best window to actAsk for the itemized bill, compare it with your insurer’s explanation of benefits, and apply for financial assistance.
- Within 30 days of a complete application The hospital must decideIn writing, with the reason and your right to appeal. While the application is pending, the account may not go to collections.
- Days 1–180 No collections, no lawsuitA collection notice that arrives inside this period is itself a violation of the 2024 rules.
- After day 180 The account may go to a collection agencyYou can still apply for financial assistance. Ask the collector to validate the debt in writing.
- Any time No credit reporting by New York hospitals, providers or ambulance servicesState law since December 13, 2023. The bureaus also wait a year before showing a new medical collection, and skip those under $500.
- Within 3 years of treatment The only period in which a lawsuit can be filedAnd only if your household income is above 400% of the poverty level, which the hospital’s chief financial officer must attest first.
- After a judgment Interest of no more than 2% a yearNo wage garnishment and no lien on your primary residence for medical debt, since November 2022.
The 180 days, the 30-day decision and the 400% line come from the 2024 amendments to Public Health Law section 2807-k, in force since October 20, 2024. They bind every hospital licensed in New York, including for-profit hospitals. Every law with its date.
What can and cannot happen in New York
| What people fear | Can it happen in New York? | The rule |
|---|---|---|
| The bill goes to collections | Yes, but not within 180 days of the first hospital bill or while an assistance application is pending | Public Health Law 2807-k, since Oct 20, 2024 |
| It shows up on my credit report | Not legally, from a New York hospital, provider or ambulance service | Fair Medical Debt Reporting Act, since Dec 13, 2023 |
| The hospital sues me | Only if household income is above 400% of the poverty level, after 180 days, within 3 years of treatment | 2024 amendments; CPLR time limit since 2020 |
| My wages are garnished | No, for medical debt from hospitals and health care professionals | Law signed Nov 23, 2022 |
| A lien on my home | No lien on your primary residence for medical debt | Law signed Nov 23, 2022 |
| Interest piles up | Judgment interest capped at 2% a year, down from 9% | Since Apr 30, 2022 |
| Jail | No. An unpaid medical bill is a civil debt, not a crime | |
| Losing future care | A hospital emergency department must still screen and stabilize you | Federal EMTALA |
Two of those rows depend on income. At or below 200% of the poverty level, $31,920 a year for one person or $66,000 for a family of four in 2026, a New York hospital may not charge an uninsured patient anything under its financial assistance program. Between 201% and 300% the charge is capped at 10% of the Medicaid rate, and between 301% and 400% at 20%. Run your numbers.
Your credit report: the law and the fight over it
New York’s Fair Medical Debt Reporting Act bars hospitals, licensed health care professionals and ambulance services from reporting medical debt to consumer credit bureaus, requires their contracts with collectors to forbid it, and makes medical debt reported in violation void. It took effect December 13, 2023.
In July 2025 a federal court vacated a federal rule that would have removed medical debt from credit reports nationwide, and said federal law preempts state bans. The federal consumer bureau agreed in October 2025. New York’s law was not struck down, but expect a collector to argue it no longer applies.
Two protections do not depend on either law, because the three big credit bureaus apply them on their own: paid medical collections are removed, unpaid medical collections under $500 are not reported, and a new medical collection waits a year before it can appear. How to check and dispute an entry.
Doctors, labs and ambulances follow different rules
Most of the timeline above is hospital law. A bill from a physician group, a lab or an ambulance company follows some of the same rules and not others.
| Rule | Hospitals | Other providers |
|---|---|---|
| Financial assistance tiers to 400% FPL | Yes | No, though many will negotiate |
| 180 days before collections or a lawsuit | Yes | No |
| No lawsuit under 400% FPL | Yes | No |
| No credit reporting | Yes | Yes, for licensed providers and ambulance services |
| No wage garnishment, no home lien | Yes | Yes, for health care professionals |
| Three-year time limit to sue | Yes | Yes |
| 2% cap on judgment interest | Yes | Yes |
A bill from a hospital outside New York follows that state’s law, not this one.
If you have insurance
Insurance does not take you out of the financial assistance program. If your out-of-pocket medical costs over the last 12 months exceed 10% of your gross income, New York treats you as underinsured, and the same income tiers apply to your share of the bill.
Before paying anything, put the bill next to your insurer’s explanation of benefits. If the hospital asks for more than the “patient responsibility” line, that difference is the first thing to dispute. If a doctor you did not choose billed you out of network at an in-network hospital, it may be a surprise bill that is not yours to pay.
What to do, in order
- Do not ignore the bill, and do not pay it in full yet. Write the date of the first bill on the envelope. Your 180 days start there.
- Ask for the itemized bill by name, in writing. The errors that repeat.
- Apply for financial assistance on New York’s uniform application, even if you have insurance and even if you think your income is too high. Immigration status may not be considered, and no asset information may be required.
- Keep everything in writing, with the account number at the top of each letter, and note the date the hospital received your completed application. The decision is due within 30 days.
- If a collector calls, ask for validation of the debt in writing and end the call. Then send the letter.
- If a payment plan makes sense, a hospital may not set your monthly payment above 5% of your gross monthly income or charge more than 2% interest. On $3,000 a month, that is a payment of no more than $150.
- If court papers arrive, answer them by the deadline. New York City funds free legal services, and “medical debt” plus “I have been served” moves a case up an intake queue.
Questions people ask
What happens if you don’t pay a medical bill in New York?
You get more statements and calls. After 180 days from the first bill, a hospital may send the account to a collection agency, unless a financial assistance application is pending. It may not report the debt to credit bureaus, garnish your wages or put a lien on your home, and it may not sue you if your household income is under 400% of the poverty level.
How long before a medical bill goes to collections in New York?
At least 180 days after the first bill from a hospital, and not while your financial assistance application is pending. Other providers, such as a physician group, are not bound by the 180-day rule.
Can a hospital sue you for an unpaid bill in New York?
Only if your household income is above 400% of the federal poverty level ($63,840 for one person in 2026), only after the hospital’s chief financial officer attests to that, only after 180 days from the first bill, and only within three years of the treatment.
Will an unpaid medical bill hurt my credit in New York?
It should not. New York law bars hospitals, providers and ambulance services from reporting medical debt to credit bureaus. That law’s enforceability is contested in federal court, so check your reports; the bureaus’ own rules keep unpaid medical collections under $500 off them regardless.
Can I go to jail for not paying a medical bill?
No. An unpaid medical bill is a civil debt, not a crime. The one court risk is a lawsuit you do not answer, which can end in a default judgment.
Can they take my house or my paycheck for medical debt?
No. Since November 23, 2022, hospitals and health care professionals in New York may not garnish wages or place a lien on a primary residence to collect a medical debt judgment.
How long can a medical bill be collected in New York?
A lawsuit over medical debt must be filed within three years of the date of treatment. Collectors may keep asking after that, but the time to sue has passed.
Can I still get financial assistance after the bill went to collections?
Yes. New York lets you apply for hospital financial assistance at any stage, including after the account has gone to a collection agency.
Sources
- New York State Attorney General — Hospital financial assistance (checked 2026-10-07)
- NYS Department of Health — Dear CEO letter DAL 24-01 on the 2024 financial assistance amendments (October 18, 2024) (checked 2026-09-07)
- New York State Senate — S.4907A, Fair Medical Debt Reporting Act (checked 2026-09-07)
- Health Care for All New York — what the medical debt protections mean (checked 2026-09-07)
More in Medical Debt in New York: What Collectors Can and Cannot Do
- Medical Debt on Your Credit Report in New York: What the Law Says and What Actually Happens — New York has banned credit reporting of medical debt by hospitals and providers since December 2023. A federal court fight clouds that. How to dispute an entry.
- Medical Debt and Bankruptcy in New York: When It Matters and What to Try First — Most New York medical bills never need bankruptcy: hospitals cannot sue under 400% FPL or garnish wages. When filing matters, and free help in NYC.
- New York Medical Debt Laws: Every Protection, With the Date It Took Effect — Free and capped hospital care to 400% FPL, no lawsuits under 400%, no wage garnishment, home liens or credit reporting: New York medical debt law, with dates.
This page explains how the system works. It is not medical advice. More.