Medical paperwork is the only mail that arrives in pairs that disagree. The clinic sends a bill, your insurer sends an explanation of benefits (EOB), and the two numbers rarely match on the first try.
The short version, for the US: keep undisputed medical bills for a year. That's on the FTC's current "Keep for a Year" list. Keep each EOB at least as long as the bill it explains. Keep anything in dispute until the dispute is fully over, however long that takes. Keep a Medicare Summary Notice at least until the appeal date printed on it has passed. And if you deducted medical expenses, the bills behind that deduction become tax records and stay with that year's return.
For every other paper in the house, see the master retention chart.
How long to keep each kind of medical paperwork
| Document | Keep for | Why / source |
|---|---|---|
| Medical bill, paid and undisputed | 1 year | On the FTC's June 2025 "Keep for a Year" list as "undisputed medical bills" |
| Medical bill in dispute, or with a claim still open | Until the dispute or claim is fully closed | No official cap; an open dispute is the reason to keep it |
| EOB from your health insurer | As long as the matching bill; about 1 year is common practice | No federal period; the FTC says keep EOBs in a safe place |
| Medicare Summary Notice (MSN) | At least until the appeal date on it has passed | Medicare's sample notice: "You have 120 days to appeal your claims" |
| Bills, EOBs and receipts behind a medical deduction | With that year's tax records, generally 3 years after filing | IRS Publication 502: keep records that support the deduction |
| Self-pay bill plus your Good Faith Estimate | At least 120 days from the bill date, longer if you dispute | CMS dispute process for people not using insurance |
| Receipts for care paid from an HSA or FSA | Separate rules | See HSA and FSA receipts |
Why a year is the usual answer for bills
The one-year mark isn't arbitrary. Medical billing is slow. A claim goes from the provider to the insurer and back, the EOB shows up, then a revised bill arrives, sometimes months after the visit. A year gives all of that time to settle, and gives you time to notice if you're paying twice or paying for something you never got.
The FTC's older "pack rat's guide" adds the obvious exception: shred medical bills after one year "unless you have an unresolved insurance dispute." A bill under dispute is evidence; keep it until the argument is over.
When you do let them go, shred them. The FTC's guidance on medical identity theft says to keep medical records, health insurance records and EOBs in a safe place, and to shred them before you throw them away. A medical bill carries your name, your insurance details and a list of what you were treated for, which is exactly what someone needs to bill care in your name.
EOBs: the paper that catches billing mistakes
An EOB is not a bill. It's your insurer's account of a claim: what the provider charged, what the plan paid, and what's left for you. Its whole job is to be compared against the provider's bill before you pay.
A routine that takes two minutes per bill:
- When a bill arrives, find the EOB for the same date of service.
- Check that the amount the bill asks for matches what the EOB says you owe.
- If they don't match, call the provider's billing office before paying, and write down who you spoke with and when.
- Once the bill is paid and the numbers agree, keep the two together.
No federal agency sets a period for EOBs, so keep each one as long as the bill it explains. If you've already thrown one away, you're not stuck. Under HIPAA you have the right, with few exceptions, to copies of the billing records your health plan and providers hold, and a provider can't refuse because you haven't paid. Your doctor normally has up to 30 days to provide them. Pulling those records together is part of organizing medical records, and if you're wondering how long the provider keeps its own copies, that depends on your state.
Medicare Summary Notices and the 120-day appeal window
If you have Original Medicare, a Medicare Summary Notice (MSN) arrives in the mail at least twice a year. Medicare.gov is blunt about it: "It's not a bill." It lists the Part A and Part B services billed to Medicare, and Medicare tells you to keep your receipts and bills and compare them to your MSN to be sure you got everything listed.
The MSN also carries a deadline. Medicare's sample Part B notice says: "You have 120 days to appeal your claims." The exact date sits in a box on the notice, and it's the date your appeal must be received. Appeals in Original Medicare start from the MSN itself, so if a claim looks wrongly denied, that notice is the document you need.
Medicare.gov doesn't say how long to keep an MSN. A sensible practice: keep each one until its appeal date passes (longer if it's tied to an appeal), and file the rest with that year's bills.
If you pay without insurance
People who told a provider they weren't using insurance have a separate federal dispute process. CMS says you can dispute the bill if it's at least $400 more than the Good Faith Estimate you were given, and the initial bill is dated within the last 120 calendar days. So for self-pay care, keep the Good Faith Estimate and the bill together, at least until that 120-day window closes. This process doesn't cover bills for care you ran through insurance.
Medical bills and your taxes
If you deduct medical expenses, IRS Publication 502 says: "You should keep records of your medical and dental expenses to support your deduction. Don't send these records with your paper return." From that point, the bills, EOBs and receipts are tax records. In the US, generally, the IRS says to keep records that support your return until the period of limitations for that return runs out, which is 3 years after filing in the ordinary case and longer in a few unusual ones. Check IRS.gov for the current wording before you shred anything that went into a return.
Where to keep them
On an iPhone, the Files app handles it with nothing to install. Open Files, tap the More button (the three dots), tap Scan Documents, and hold the page in view; in Auto mode it captures by itself. Choose a folder, say "Medical 2026", and tap Save. Rename each scan with the provider and the date of service, and the bill-to-EOB matching gets much faster.
If renaming every scan is the step you'll skip, Paperlock reads each bill or EOB as you save it, notes who it's from, the date and the amount, and keeps it behind Face ID with medical documents blurred until you confirm. "What did I pay the dermatologist last spring?" then gets an answer with the bill attached.