9/2/2023 0 Comments Charged synonymWhat are the new protections if I have health insurance? People with Medicare and Medicaid already enjoy these protections and are not at risk for surprise billing. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill. ![]() In addition to any out-of-network cost sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This could have left you with higher costs than if you got care from an in-network provider or facility. Here’s what you need to know about your new rights.īefore the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, even unknowingly, your health plan may not have covered the entire out-of-network cost. If you disagree with your bill, you may be able to dispute the charges. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit. If you have private health insurance, these new protections ban the most common types of surprise bills. ![]() Starting in 2022, there are new protections that prevent surprise medical bills. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider. The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
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