survey shows how little it takes to end up in collections

The finances of many Americans are so fragile, even a few thousand dollars in unforeseen medical expenses can drive them from the doctor to the debt collector, a new poll shows.

How fragile? More than half (56 percent) of respondents had medical debt sent to collections and nearly two-thirds owed under $5,000, while 5 percent owed over $50,000. 

According to respondents, hospitalization accounts for a quarter of the medical debt. The next three causes are:

  • Diagnostic test (X-rays, MRIs, lab fees) – 22 percent
  • Emergency room visits – 19 percent
  • Doctor visits – 15 percent

Interestingly, three-fifths of respondents never tried to negotiate their medical bills. Only a little more than a third tried to, and a small 5 percent hired a medical billing advocate.

Here are some of the most interesting findings…

Nearly half have outstanding medical bills or debt


46% of a survey respondents have outstanding medical bills or medical debt.

The majority of those respondents said they had those medical bills sent to collections


56% of survey respondents said their medical bills were sent to collections.

Most survey respondents claimed to have between $1,000 and $5,000 worth of medical debt


32% of survey respondents with medical debt said they had between $1,000 and $5,000.

3 out of 5 with medical debt said they never tried to negotiate with a hospital billing department


60% of those with medical debt said they've never tried to negotiate their bills.

Do you have outstanding medical bills or medical debt? Yes No
Percentage of respondents 45.87% 54.13%
Have your medical bills been sent to collections? Yes No Unsure
Percentage of respondents 56.16% 30.78% 13.06%
How much do you owe? Percentage of respondents
Less than $500 13.77%
$500 to less than $1,000 18.55%
$1,000 to less than $5,000 31.93%
$5,000 to less than $10,000 14.91%
$10,000 to less than $50,000 15.30%
$50,000 to less than $100,000 3.06%
$100,000 to less than $150,000 0.96%
$150,000 or more 1.53%
What type of health insurance do you have? Percentage of respondents
Employer-provided 43.13%
Medicare or Medicaid 36.17%
Self-purchased through an exchange 8.90%
None 11.80%
What is the primary source of your medical debt? Percentage of respondents
Hospitalization 24.80%
Diagnostic tests 21.68%
Emergency room 18.95%
Doctor visits 14.84%
Outpatient services 10.94%
Dental care 4.30%
Prescription drugs 3.71%
Nursing home/long-term care 0.78%
How did your insurance company respond to your medical bills? Told me I received out-of-network care Denied my claim
Percentage of respondents 55.80% 44.20%
Have you tried negotiating to lower the cost of your bills? No Yes, I tried to negotiate on my own Yes, I used a medical bills advocate
Percentage of respondents 60.52% 34.55% 4.94%
Were you successful in this negotiation? Yes No
Percentage of respondents 27.47% 72.53%
Are you currently on a payment plan? Yes No
Percentage of respondents 36.50% 63.50%

For media contacts available on press release of this research.

Methodology: surveyed 1,186 people and asked nine questions related to their medical debt. People responded from all 50 states and Washington, DC and were aged 18 and above. Responses were collected through SurveyMonkey. The survey was conducted from June 17, 2020 to July 6, 2020.