No Surprises Act and
Good Faith Estimate Notice

Your Rights and Protections Against Surprise Medical Bills

Federal and state laws provide protections from certain types of surprise medical bills and balance billing. These protections most commonly apply to emergency services and certain services provided by out-of-network providers at in-network hospitals or facilities.

What is “balance billing” (sometimes called “surprise billing”)?

Balance billing generally refers to an out-of-network provider billing a patient for the difference between the provider’s charge and the amount paid by the patient’s health plan. Federal and state laws prohibit balance billing in certain circumstances.

When balance billing protections apply:

Under federal law, patients are protected from balance billing for certain emergency services and certain non-emergency services received from an out-of-network provider at an in-network hospital or facility. New York, New Jersey, and Connecticut also provide protections against surprise billing in certain circumstances.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Good Faith Estimate:

If you do not have health insurance, or if you have insurance but choose not to use it to pay for your care, you have the right to receive a Good Faith Estimate explaining how much your care is expected to cost.

You may request a Good Faith Estimate before scheduling services. If you schedule services at least three business days in advance, you are generally entitled to receive an estimate before your appointment.

If you receive a bill from a provider that is at least $400 more than the amount listed on your Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process.

Please keep a copy of your Good Faith Estimate for your records.

If you believe your rights under the No Surprises Act have been violated, you may contact the federal No Surprises Help Desk at 1-800-985-3059.

You may also contact the appropriate state agency:

New York: New York State Department of Financial Services
New Jersey: New Jersey Department of Banking and Insurance / Division of Consumer Affairs
Connecticut: Connecticut Insurance Department

For more information about your rights under federal law, visit the Centers for Medicare & Medicaid Services No Surprises Act website or call 1-800-985-3059.