Debt Collection / Medical Hardship Letter

How to Write a Hardship Letter for Medical Bills

Written by Ben Tejes
Updated Nov 13th, 2023
The information provided in this article does not, and is not intended to, constitute legal or financial advice; instead, all information, content, and materials available in this article are for general informational purposes only. 

When unexpected medical events happen, it can be hard to stay on top of the costly bills that come along with them. From broken arms to difficult diagnoses, any hospital visit can take you from a place of relative financial stability to struggling to make ends meet. When this happens, what are your options? How can you move forward under the weight of crippling medical debt? One of the many ways to help with that debt is a hardship letter. 

This article will look at what a hardship letter is, how it can help, and how you can write one. Keep reading to learn more.

What is a Medical Hardship Letter?

A medical hardship letter is simple, yet powerful. Individuals who find themselves overwhelmed with medical debt have the option to send in a medical hardship letter. A medical hardship letter contains a plea for leniency and potential forgiveness of debts — either partial or whole. When writing a medical hardship letter, you explain to the hospital or entity controlling your debt that you are unable to pay your medical debts.

Once you have written this letter, you will send it to the hospital or entity controlling your debt with the hopes of a favorable response. But what exactly are some of the ways a hardship letter can help? Let’s take a closer look!

How Does a Medical Hardship Letter Help?

There are a couple of different preferable outcomes that could come from a hardship letter. Here are a few of the best things that could come out of a medical hardship letter. Below is a debt forgiveness calculator that can help you estimate your cost and options when you face a medical hardship.

Here are some different outcomes of the medical hardship letter:

Debt Forgiveness (full)

In some cases, there may be a chance for debt forgiveness. Typically this happens in particular situations. These situations may include ones where either the debtor had been making regular payments on the debt, got it down to a small amount, and then had an unexpected financial hardship. Because the amount of unpaid debt is small, it may not be worth the time of the hospital to come after you for the debt. If you were to just try to ignore the debt, there is a chance the hospital would sell the debt to a collection agency. However, if you write a hardship letter, there is a chance that the hospital will instead opt to cancel the remaining debt.

Debt Settlement (Partial Forgiveness)

Another possible outcome is that the letter will begin the process of debt settlement. If you have debt you still owe, but have missed several payments, the hospital may consider accepting a lower payment amount for the sum of the debt. For instance, if you owe $5,000, there is a chance the hospital may accept $3,000. Once the $3,000 is paid, you would no longer owe the hospital anything. 

Delinquent Account Leniency

 One of the more common outcomes of a medical hardship letter is leniency. If you were to simply ignore the fact that you were missing payments, there are many avenues of debt collection for a hospital. From lawsuits to debt collection agencies, hospitals can find ways to come after you for your debt. However, if you acknowledge the debt and explain your situation, there is a chance the hospital will instead be patient and lenient, especially if you include your plan to repay the debt.

Regardless of what you are hoping comes out of the medical hardship letter, the biggest thing this letter does is begin the communication with the hospital. As we mentioned earlier, the worst thing you can do is ignore debt that you cannot pay. Reaching out to the entity that holds your debt is the first step to obtaining a solution that works for you. So, how can you write a medical hardship letter? Here are a few things you need to include in the letter.

How to Write a Medical Hardship Letter

There are a few necessary pieces of information that will be helpful to include in this letter. Not only do you want this letter to be informative and logical, but you also want it to be persuasive and emotional. Balancing this can be difficult, but it is definitely achievable. Here are a few components to keep in mind.

Monitor the Length

While you do want enough information in the letter, you don’t want to send a novel. Be direct and to the point. The preferred length is somewhere around one full page. Too short and it may seem callous, but too long and there’s a chance the letter isn’t even read. 

Introduce Yourself

Make sure the reader knows they are dealing with a real person! Tell them your name and why you have medical debt in the first place. It could sound something like this:

Hello! My name is [insert name], and I recently was a patient at [hospital or medical office] due to [medical condition or treatment]. I was so thankful for the excellent care and service you were able to provide during such a critical and scary time.

Provide Financial Information

In this next section, you want to include the necessary financial information that lays out how much the treatment cost, what your insurance covered, and what you still owe. Keep this at the top, as this is information they need to know and are most interested in. It could read as follows:

While being treated, I incurred expenses of [dollar amount]. [Dollar amount] was covered by insurance, leaving me with [dollar amount] left to pay. (If you don’t have insurance, you could write: Unfortunately, I did not have insurance, so I was left with the entirety of the bill.)

Previous Repayments

Call back to the times you have been paying your debt down. If you were making payments monthly, let them know! If you were making payments in chunks as you were able, point that out. Just make sure to include any effort you made to repay the debt. Here is an example:

After my treatment, I made regular, monthly payments of [monthly payment amount]. I made these payments every month for the past 7 months. 

Insert the Hardship

Now is the time to mention what is preventing you from making your monthly payments. You can be as detailed or as vague as you want, however, the more detailed you are, the better chance you have of getting a deal worked out. Whether it is an unexpected job loss, a death in the family, illness, or something else, mention what is stopping you from being able to make consistent payments. Here is something you could write:

Unfortunately, I have recently been laid off from my job and I have no meaningful source of income. Because of this, I am unable to make any payments on my debt. In fact, I am barely able to make ends meet with rent, groceries, and utilities. 

Provide Proof

If you are able, provide as much financial documentation as possible. Not only will this show that you are being honest about your situation, but this will also solidify your situation in the reader’s mind. Things like check stubs, total debt to the hospital, and even emails showing your situation are valuable to include. Mention them like this:

I have included the email that notified me of my termination of employment, as well as my previous check stubs, rent statements, and hospital debt statements. As you can see, without a meaningful source of income it is impossible for me to pay both my rent and hospital bills.

Suggest a Solution

Towards the end of the letter, suggest a solution! Whether you are able to make smaller payments, want to completely settle your debt, or need a couple of months to get situated before resuming payments, let them know what your plan is and ask if they are willing to consider it! Here are a few examples based on your desired outcome:

To Settle:

Fortunately, I have a savings account for times such as this. While my savings account is significant, it would not completely cover the debt in its entirety. Though my debt is $5,000, I have $3,000 I can pay immediately. If I did this, could we consider the debt fully paid? This way, I could move forward towards financial stability with one less payment to worry about, and you have one less payment you have to keep track of. 

To Lower Payment:

Though my income is significantly stalled at the moment, I would like to continue making smaller payments as a gesture of good faith. Would you be willing to accept [lower dollar amount] per month until I am able to resume working?

To Stall Payments:

I am actively working on obtaining a new job. During this time, however, I am unable to make any payments to the hospital. I estimate it will take me [number of days, weeks, months] to get a new job and resume bringing in paychecks. Would you consider allowing me to pause my payments for [amount of time] so that I can get a job and resume making payments afterward?

Provide Contact Information and a Thank You

You obviously want to end with gratitude, but also with a call to action. Leave the ball in their court and ask them to contact you with their thoughts. It could look something like this:

Thank you for your thoughtful time and consideration. I hope we are able to come to an agreement that works for both of us. Please reach out at [contact information] so we can discuss the details of this arrangement.



Need Any More Help With a Hardship Letter?

Hopefully, this medical hardship letter will help you with any financial struggles you may be facing due to a medical emergency. Contact Ascend if you’d like help figuring out what your next step is!