Here’s what does and doesn’t happen in SC if you’re unable to pay your medical bills

If there’s one thing that the U.S. is well-known for, it’s that it’s not cheap to go to the hospital.

All it takes is one accident to land you with an enormous medical bill, sometimes even if you have insurance. In the U.S., an emergency room trip costs about $2,863 on average in 2026, according to a report from Mira Health, and can be even more costly if imaging, labs, medications or specialist charges are added.

Without insurance, extensive care, such as surgeries or multiple CT scans, can make bills climb upwards to $21,000 or more.

South Carolina’s emergency room visits are usually cheaper than the national average, with the average bill being $2,124, but that is still too expensive for many South Carolinians. According to SC Law Review, the principal legal publication in the state, South Carolina has one of the highest rates of past-due medical debt.

So what happens if you receive a medical bill that you’re not able to afford? Will the hospital send a debt collector to your door and demand a paycheck?

Not exactly. Here’s what SC law says about not paying your medical debt:

What happens if I don’t pay my medical bills in SC?

Medical bills are considered civil debts, so you won’t be criminally charged because you didn’t pay your hospital bills. However, you can be sued for medical debt by hospitals, debt collectors and debt buyers.

If you receive a Summons and Complaint, you must file a written answer with the court and mail a copy to the plaintiff’s attorney within 30 days. If you ignore it, the court will issue a default judgment against you. The provider has three years from the date the debt came due to sue you; otherwise, the debt becomes time-barred.

Wages cannot be garnished in the Palmetto State for most private medical debt, according to SC Legal Services. That means you don’t have to worry about your paycheck getting touched by an outside source.

However, the state allows creditors to collect medical debt, along with certain other forms of debt, by garnishing state income tax refunds, under its Setoff Debt Collection Program.

Through this, qualifying creditors may submit claims of unpaid debt to the South Carolina Department of Revenue, which is then processed, identifies the debtors and garnishes the debtors’ tax refunds on behalf of their creditors.

Medical debt can still negatively impact your credit score in SC. Credit reporting bureaus, such as Experian and Uquifax, include medical debts more than $500 on credit reports, but only if they have been unpaid for more than a year.

Unpaid medical collection accounts over $500 can remain on your credit report for seven years after becoming delinquent; however, they will be removed once you pay the debt.

Tips to reduce hospital bills

Obviously, it’s recommended to pay all your hospital bills so you don’t have to face any consequences. If the bill you’ve received is too expensive, there are some ways to reduce it to make payments more manageable.

Most hospitals have charity care or financial assistance programs to help offset the cost of a gnarly medical bill for low-income patients. The IRS requires tax-exempt hospitals, such as Prisma Health, to establish a written financial assistance policy, and those policies can include free or discounted care for eligible patients.

If you’re uninsured or underinsured, contact the hospital’s patient advocacy department after you receive your bill. You could qualify for:

• Reduced or waived fees
• Zero-interest payment plans
• Assistance applying for Medicaid if eligible

Sometimes, there can be errors with your bill. Make sure you’ve received an itemized bill and the codes match the care you’ve received.

Additionally, hospitals may offer payment plans or discounts to those who try to negotiate. Some people have negotiated 30–50% off their original bill by discussing financial hardship, according to Mira Health.