Medical Hardship

Can i you apply for a Medical Hardship withdraw if you have not paid anything on the outstanding medical bill or do you have to have paid on the outstanding medical bill in order to apply for a Medical Hardship

If you were able to pay the bill, then it can be questionable whether you actually have a hardship. If you are asking if you need to make a partial payment, but not be able to make full payment in order to qualify for hardship, I think the answer is "no" that wouldn't make sense.