How does unpaid medical debt affect your credit score, and what factors determine the size of the impact?

How unpaid medical debt affects your credit score

Right now, unpaid medical debt can show up on your credit report and lower your score. A federal rule that would have banned all medical debt from credit reports was overturned by a court in July 2025 [1] [2] [7] [9] [11] [17]. So the older protections (and the exceptions below) are what you need to know.

But the actual hit to your credit score isn’t automatic—it depends on several specific factors. Here’s what decides whether your medical bill will affect your score, and by how much.

1. The dollar amount: under $500 doesn’t count

If your unpaid medical debt is less than $500, it has no effect on your credit score at all [4]. Only debts above that threshold can appear and cause damage.

2. It only hurts once it reaches collections

Most bills sent directly by a doctor’s office or hospital are not reported to credit bureaus [5]. The debt usually has to be handed off to a collections agency before it might show up on your report and affect your score.

3. A mandatory 365‑day waiting period

Even when a medical debt exists, the credit bureaus cannot report it until 365 days after the date of service [15]. That gives you a full year to resolve the bill, negotiate with insurance, or set up a payment plan.

4. Paying the debt wipes it away entirely

Once you pay a medical debt (even an old one), the three major credit bureaus must remove it from your credit reports completely [16]. Unlike some other collections, a paid medical debt won’t linger as a negative mark.

5. The kind of score a lender pulls changes everything

Not all credit scores are the same. Which model a lender uses determines whether your medical debt shows up at all:

• VantageScore 3.0 and 4.0 completely ignore unpaid medical collection accounts—they don’t affect those scores [18] [19] [21].
• FICO Score 9 counts unpaid medical collections, but gives them a smaller negative impact than other types of collections [20]. Older FICO models may still treat them the same as any collection.

6. Your state might offer extra protection

Some states have passed laws that restrict or forbid medical debt from appearing on credit reports. In 2025, states like Delaware, Maine, Maryland, Oregon, Vermont, and Washington enacted such restrictions [12]. Colorado also prohibits reporting medical debt information in consumer reports [14]. So where you live can reduce or eliminate the impact.

Putting it all together

Because of these layers, the same unpaid medical bill could hammer one person’s score (over $500, in collections, reported under an older FICO model, in a state with no extra law) and leave another person’s score untouched (under $500, or the lender uses VantageScore, or the state bans the reporting). The gist: amount matters, time matters, scoring model matters, and your location matters [4] [5] [12] [15] [18] [19] [20].