What Is the No Surprises Act and How Does It Protect You?
The No Surprises Act, effective January 2022, protects patients from many surprise out-of-network bills — for emergency care, and for out-of-network providers at in-network facilities. It also gives uninsured and self-pay patients a right to a good-faith estimate before scheduled care. If you received a surprise out-of-network bill in one of these situations, you can dispute it.
What the No Surprises Act covers
The law generally protects you in three situations: (1) emergency services from an out-of-network provider or facility, (2) non-emergency care from out-of-network providers at an in-network facility (for example, an out-of-network anesthesiologist at an in-network hospital), and (3) air ambulance services from out-of-network providers. In these cases you generally cannot be balance-billed beyond your normal in-network cost-sharing.
Good-faith estimates for the uninsured
If you are uninsured or self-pay, providers must give you a good-faith estimate of expected charges before scheduled care. If your final bill is substantially higher than the estimate, you may be able to dispute the difference through a patient-provider dispute resolution process.
What it does not cover
The Act does not cap all medical prices, and it does not cover every situation — ground ambulance bills, for instance, were largely left out of the federal law (though some states regulate them). It targets surprise out-of-network billing, not high in-network bills.
How to use it
If your bill fits a protected situation, say so in writing: state that the charge appears to violate the No Surprises Act, request that it be reviewed and corrected, and ask for a written response. Reference the specific circumstance (emergency, in-network facility, or air ambulance).
Frequently asked questions
Does the No Surprises Act cover ambulance bills?
It covers air ambulance services, but ground ambulance bills were largely left out of the federal law. Some states have their own protections for ground ambulances.
What is a good-faith estimate?
It is a written estimate of expected charges that providers must give uninsured or self-pay patients before scheduled care. A final bill substantially higher than the estimate may be disputable.
Does the No Surprises Act lower all my medical bills?
No. It targets surprise out-of-network billing in specific situations. It does not cap in-network prices or every charge.