The No Surprises Act: Your Protection Against Surprise Medical Bills
The No Surprises Act protects you from unexpected out-of-network bills in emergencies and certain other situations. Know your rights.
What the No Surprises Act Does
Effective January 1, 2022, the No Surprises Act protects patients from surprise medical bills in three key situations: emergency services, non-emergency services at in-network facilities from out-of-network providers, and air ambulance services. You only pay in-network cost-sharing amounts in these situations.
Emergency Services Protection
If you receive emergency care — even at an out-of-network hospital — you can only be charged your in-network copay, coinsurance, and deductible amounts. The hospital and your insurer must work out the remaining payment between themselves. This applies to both the facility and any physicians who treat you.
In-Network Facility, Out-of-Network Provider
If you go to an in-network hospital but are treated by an out-of-network anesthesiologist, radiologist, pathologist, or other provider you didn't choose, you are protected. You pay only what you would have paid for in-network care. This is one of the most common types of surprise bills.
Your Good Faith Estimate Rights
Uninsured or self-pay patients have the right to a Good Faith Estimate of expected charges before receiving care. If the final bill exceeds the estimate by $400 or more, you can dispute it through a patient-provider dispute resolution process.
How to Use This Law
If you receive a surprise bill, don't pay it immediately. Contact your insurance company and reference the No Surprises Act. File a complaint with CMS (Centers for Medicare & Medicaid Services) at 1-800-985-3059 if the provider or insurer doesn't comply.
Disclaimer: This guide is for informational purposes only and does not constitute financial or medical advice. Always consult with qualified professionals before making healthcare or insurance decisions.