The No Surprises Act explained

The No Surprises Act is a federal law in effect since January 1, 2022. It protects many people from surprise bills: charges from out-of-network providers they did not choose or could not avoid. This page is a summary to help you ask the right questions, not legal advice.

If you have health insurance

The law generally protects you from balance billing, where an out-of-network provider bills you for the difference between their price and what your plan paid, for:

• Emergency care, including at an out-of-network emergency room.
• Non-emergency care from out-of-network providers at an in-network hospital or surgery center, such as an anesthesiologist or radiologist you did not choose, unless you gave written consent in advance where the law allows it.
• Air ambulance services.

In these cases you should only owe what you would have paid in network: your usual copay, coinsurance and deductible.

If you are uninsured or paying yourself

You have a right to a good faith estimate of the cost of scheduled care. If the final bill from a provider is at least $400 more than that provider's estimate, you can start a federal patient-provider dispute process within 120 days of receiving the bill. There is a small fee to file.

What to do if you think a bill is a surprise bill

1. Compare the bill with your insurer's explanation of benefits.
2. Ask the provider whether they were in or out of network and whether the protections apply.
3. If you still disagree, contact your insurer, your state's insurance department, or the No Surprises Help Desk.

Open your bill in MedBillCheckup (it is read on your device and never uploaded) and we will line it up with your good faith estimate or explanation of benefits and list the questions to ask.