Medical debt behaves differently from other consumer debt on credit reports, thanks to changes in the past few years.

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Medical collections under five hundred dollars no longer appear on credit reports. Paid medical collections of any amount are removed. Unpaid medical collections over five hundred dollars appear only after a full year of nonpayment, and are removed from reports after seven years even if unpaid.

This is a significant departure from other collections, which appear immediately after nonpayment and remain for seven years regardless.

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The practical effect: small medical bills that go to collection have essentially no credit consequence.

Larger medical bills that reach collection do affect credit, but less than a comparable non-medical collection. FICO's newer scoring models weigh medical collections less heavily.

This does not mean medical debt should be ignored. Aggressive collectors can still sue, garnish wages, and seek judgments. But medical debt should be prioritized differently than credit card debt.

For anyone struggling with medical debt, the first priorities should be hospital financial assistance programs and negotiation, before payment.