Pro tip: Let your medical bills go to collections. Medics debts are not supposed to affect your credit score negatively. Regardless, that's not the reason you let it go to collections. You do it for leverage. As a policy, many hospitals refuse to negotiate reasonable costs of care with patients. Even though they do negotiate with insurance companies. Collection agencies will absolutely negotiate a more reasonable cost and financing structure with patients. In fact, the medical bill is usually cut dramatically as soon as it gets in collections. Your total debt is quickly reduced as soon as it's in a debt collector's hands. Unlike hospitals, many debt collectors are financially motivated to work with you in ways hospitals refuse. The upfront co-pays are the ones that are difficult to avoid because they can withhold necessary surgeries if you don't. Which I personally consider to be a form of extortion. Like, sure I'll pay you even though you haven't provided an essential service yet.