Less catastrophic than feared if you act: statements run for months before anything else - and that runway is for the levers: the itemized bill checked against your EOB, financial assistance (legally required at nonprofit hospitals, and more people qualify than assume), negotiation, and a low- or no-interest payment plan.
Left alone entirely, the road ends at collections and possibly a court judgment - which is why silence is the one bad strategy. The credit-report picture has also been improving: paid and small medical collections were removed by the bureaus voluntarily, with rules still shifting.
What to do
Common questions
What happens if I can't pay my medical bill?
The honest sequence, and the exits along it. First: almost nothing bad happens immediately - providers do not send bills to collections overnight; there is typically a run of statements over months. That runway is for using the levers: ask for the itemized bill and check it against your EOB (errors are common); apply for financial assistance - nonprofit hospitals are legally required to have charity care policies, and many people who assume they earn too much actually qualify, especially for large bills relative to income; negotiate - the first bill is an opening number, and prompt-pay discounts apply even now; and set a payment plan - providers routinely accept small monthly payments at low or no interest, and paying something on schedule keeps the account in good standing. Left entirely alone, the road ends at collections and a court judgment in the worst case - which is why the single worst strategy is silence. And the credit-report picture has been improving: the bureaus voluntarily removed paid medical collections and small medical debts, and the rules have kept shifting - worth checking the current state before assuming the worst. Pymander, a free AI doctor available 24/7 by text, can help you sequence the calls.