Your Rights and Protections Against Surprise Medical Bills
No Surprises Act Balance Billing Protections
The No Surprises Act protects patients from large and unexpected surprise bills for out-of-network emergencies and certain non-emergency services provided in in-network health care facilities. When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance, and/or deductible.
- Disclosure Notice Regarding Patient Protections (PDF, 347KB)
- View Listing of State Summaries (PDF, 223KB)
Interpreters are available, please contact your provider for assistance.
عربي (Arabic) (PDF, 395KB)
հայերեն (Armenian) (PDF, 219KB)
bosanski (Bosnian) (PDF, 221KB)
繁體中文 (Chinese Simplified) (PDF, 282KB)
中國傳統的 (Chinese Traditional) (PDF, 348KB)
Nederland (Dutch) (PDF, 218KB)
Suomalainen (Finnish) (PDF, 208KB)
Français (French) (PDF, 222KB)
Deutsch (German) (PDF, 223KB)
Kreyòl ayisyen (Haitian Creole) (PDF, 217KB)
Hmoob (Hmong) (PDF, 217KB)
한국인 (Korean) (PDF, 282KB)
Русский (Russian) (PDF, 221KB)
Español (Spanish) (PDF, 218KB)
Tagalog (PDF, 213KB)
український (Ukrainian) (PDF, 221KB)
Tiếng Việt (Vietnamese) (PDF, 244KB)
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. Uninsured and self-pay patients also may request a good faith estimate.
- Good Faith Estimate Self Pay Notice (PDF, 347KB)
Interpreters are available, please contact your provider for assistance.
عربي (Arabic) (PDF, 395KB)
հայերեն (Armenian) (PDF, 219KB)
bosanski (Bosnian) (PDF, 221KB)
繁體中文 (Chinese Simplified) (PDF, 282KB)
中國傳統的 (Chinese Traditional) (PDF, 348KB)
Nederland (Dutch) (PDF, 218KB)
Suomalainen (Finnish) (PDF, 208KB)
Français (French) (PDF, 222KB)
Deutsch (German) (PDF, 223KB)
Kreyòl ayisyen (Haitian Creole) (PDF, 217KB)
Hmoob (Hmong) (PDF, 217KB)
한국인 (Korean) (PDF, 282KB)
Русский (Russian) (PDF, 221KB)
Español (Spanish) (PDF, 218KB)
Tagalog (PDF, 213KB)
український (Ukrainian) (PDF, 221KB)
Tiếng Việt (Vietnamese) (PDF, 244KB)