Patients have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Good Faith Estimate
Under the law, health care providers need to give patients who don’t have insurance or who
are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any
non-emergency items or services. This includes related costs like medical tests,
prescription drugs, equipment, and hospital fees. - Make sure your health care provider gives you a Good Faith Estimate in writing at least
one business day before your medical service or item. You can also ask your health care
provider, and any other provider you choose, for a Good Faith Estimate before you
schedule an item or service. - If you receive a bill that is at least $400 more than your Good Faith Estimate, you can
dispute the bill. - Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit
www.cms.gov/nosurprises or call 1-800-985-3059.
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible amounts.
The Consolidated Appropriations Act of 2021 established several new requirements to protect consumers from surprise medical bills. These requirements are collectively referred to as “No Surprises” rules. These requirements generally apply to items and services provided to consumers enrolled in group health plans, group or individual health insurance coverage, and Federal Employees Health Benefits plans. This document contains information on frequently asked questions from providers and facilities regarding No Surprises rules, independent dispute resolution, and exceptions to the new rules and requirements.