Medical debt hurts your credit score less than it used to, and how much depends on which score a lender pulls. Newer scoring models count medical collections less or ignore them entirely, while older FICO versions still count them in full. Before you apply for a mortgage or car loan, ask the lender which score it uses.
That question matters most for a mortgage. Since September 9, 2026, every lender that sells loans to Fannie Mae and Freddie Mac can score you with VantageScore 4.0. For decades, those loans required Classic FICO, the older FICO 2, 4, and 5 scores.
For medical debt, the choice only matters if a collection is on your report, and most stay off. Equifax, Experian, and TransUnion leave off paid medical collections, any with an original balance under $500, and unpaid ones until they’re a year past due. What can remain is an unpaid collection of $500 or more that’s at least a year past due.
For that collection, the score a lender pulls decides what it costs you. VantageScore 4.0 has ignored medical collections since January 2023, and FICO 9 counts unpaid ones less than other collections. FICO 8, the most widely used version, counts a medical collection like any other, and so does Classic FICO.
Ask each mortgage lender whether it will use Classic FICO or VantageScore 4.0 on your loan, because the choice is the lender’s. With a medical collection on file, get at least one quote from a lender that uses VantageScore 4.0.
Car lenders and card issuers often use FICO 8 or a FICO Auto or Bankcard Score built for their loans. Ask which score and version before the lender runs your credit. If it’s FICO 8, expect the collection to count in full.
If a medical collection the bureaus say they leave off shows up on your report anyway, dispute it.
If you can pay the collection off before you apply, do it. A medical collection paid in full drops off all three reports once the collector marks it paid, and no score can count what isn’t there.
If you’re shopping for a mortgage, compare the best mortgage lenders.
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