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Know Your Rights with the No Surprises Act!

Ever been shocked by a surprise medical bill? You’re not alone. Fortunately, the No Surprises Act is here to help.

What is a Good Faith Estimate?

Simply put, it’s a detailed expectation of what your medical care will cost. Whether you’re insured, uninsured, or somewhere in between, healthcare providers have to give you a heads-up about expenses like tests, medications, and hospital fees.

A Few Key Points:

  1. Expect a written Good Faith Estimate at least a day before your service.
  2. Feel free to ask for this estimate from any provider before you set an appointment.
  3. Got a bill that’s $400 more than your estimate? You can challenge it!
  4. Keep a copy or snap a pic of your estimate. It’s handy for future reference.
For more details or questions? Head over to www.cms.gov/nosurprises or call the friendly folks at the No Surprises Help Desk: (800) 985-3059

Unexpected Medical Bills? Know Your Safety Nets!

Sometimes, emergencies happen or you end up with an out-of-network provider at an in-network place. Surprise! But, safeguards ensure you don’t get a shocker bill.

Quick Terms Breakdown:

  • Out-of-Network: Providers without a deal with your health plan.
  • Balance Billing: When you’re charged the difference between what your plan pays and the full cost.
  • Surprise Billing: A surprise ‘balance bill’, especially when you had no say in the care providers.

Your Safety Nets Include:

  1. Emergency Services: Had an emergency? Even if the care was out-of-network, you’ll only be billed as if it was in-network. No surprise extra costs!
  2. Services at In-Network Places: Sometimes, an in-network hospital might have out-of-network professionals. They can’t charge you extra unless you agree to it.

Remember:

  • You’re only on the hook for your usual costs – like copays and deductibles.
  • Your plan covers emergency services without needing a green light first.
  • What you pay should match what you’d pay an in-network provider.
  • Paid too much in an emergency? Those payments count towards your deductible and yearly out-of-pocket limit.
Got a billing puzzle? Visit www.cms.gov/nosurprises to learn more about your rights!
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