Bill Pushback / Hardship letter

A hardship letter for medical bills

Say in a few lines why you can't pay the full bill, and ask the billing office to reduce it, forgive it, or review it for financial assistance.

Your nameYour mailing addressBilling officeIts addressPatient nameAccount numberBalance on the billWhat changed, in a few linesWhat you can pay, if anything

[Your name]
[Your mailing address]

[Today's date]

[Billing office name]
[Billing office address]

Re: Hardship request. Patient: [Patient name]. Account: [Account number].

To the billing office:

I am writing about the balance of [balance] on this account. I am not able to pay this bill in full.

[What changed: a job loss, an illness, other bills, and when it happened]

I can pay [what you can pay]. I am asking you to reduce the balance, forgive part or all of it, or review this account for financial assistance. Please tell me what documents you need, and I will send them.

Please hold this account, and do not send it to a collection agency, while you review this request.

Thank you,

[Your name]

General information, not legal, medical or financial advice. Ask a lawyer before acting on it.

What to put in it

What changed, and when: a job loss, a long illness, another large bill.
Your money in numbers. If your take-home pay is $2,600 a month and rent, utilities and other fixed bills are $2,300, say so: $300 a month is left for everything else.
What you can pay, if anything.
What you are asking for: a reduction, forgiveness, or a financial assistance review.

Keep it short and true

Three or four plain sentences are enough. Keep copies of anything you send, such as pay stubs or a layoff notice.

Ask for the policy too

A hospital may have a written financial assistance policy with its own application. The financial assistance letter asks for it.

Questions people ask next

What is a hardship letter?

A short letter to the billing office that explains why you can't pay a bill in full and asks it to reduce, forgive or review the balance.

Should I send proof of income?

Ask the billing office what it needs. Send copies, never originals, and keep a list of what you sent.

Hardship letter or financial assistance application?

They can go together. A hospital with a financial assistance policy may have its own form; the letter explains your situation in your words.

Can I send a hardship letter to a collection agency?

You can, but first ask the collector to prove the debt with the collections letter, before you agree to anything.

For the phone calls

The Medical Bill Fight Kit

A 9-page PDF you print: the order of steps, word-for-word call scripts for the billing office, your insurer, financial assistance and a collection agency, five letters with blanks (the three free ones here, plus a financial assistance request and a payment agreement confirmation) and a call and mail log.

$9 Buy the kit

If the file doesn't work or isn't what this page describes, write to us within 14 days for a full refund.