Your Rights and Protections Against Surprise Medical Bills

Last updated December 22, 2025

Under federal law, you have important protections against surprise medical bills.

The No Surprises Act, passed as part of the Consolidated Appropriations Act of 2021, protects patients from unexpected medical bills in certain situations. This law limits what you can be charged for emergency services or for care provided by out-of-network providers in specific circumstances. It also gives uninsured and self-pay patients the right to receive a Good Faith Estimate of the cost of care.

What Is “Balance Billing” (Sometimes Called “Surprise Billing”)?

When you see a health care provider, you may be responsible for out-of-pocket costs such as a copayment, coinsurance, or deductible. If you receive care from a provider or facility that is out of your insurance plan’s network, you may have to pay more—or even the full cost of care.

Out-of-network providers are those who do not have a contract with your insurance plan. In some cases, these providers may bill you for the difference between what your insurance pays and the full charge for a service. This practice is known as balance billing. These charges are often higher than in-network costs and may not count toward your annual out-of-pocket maximum.

Surprise billing occurs when you receive an unexpected balance bill, often in situations where you had little or no control over who provided your care, such as:

  • Emergency services

  • Care at an in-network facility where an out-of-network provider was involved without your knowledge

The No Surprises Act generally prohibits providers from billing patients more than the applicable in-network cost-sharing amount in these situations.

You are never required to waive your protections against balance billing. You also are not required to receive care from out-of-network providers and may choose a provider or facility within your insurance network whenever possible.

In addition to federal protections, state laws may provide additional safeguards against balance billing.

If You Believe You’ve Been Wrongly Billed

If you think you’ve received a bill that violates your protections, you may contact:

  • U.S. Centers for Medicare & Medicaid Services (CMS)
    Phone: 1-800-MEDICARE (1-800-633-4227)
    Website: https://www.cms.gov/nosurprises

  • Your state’s Department of Insurance or Department of Health Insurance

Your Right to a Good Faith Estimate

If you do not have health insurance or are not using insurance, you have the right to receive a Good Faith Estimate of the total expected cost of your medical care.

You may request a Good Faith Estimate:

  • When scheduling services

  • Before scheduling services

Timing Requirements:

  • If services are scheduled at least 3 business days in advance, you are entitled to receive a written Good Faith Estimate within 1 business day after scheduling.

  • If services are scheduled at least 10 business days in advance, you are entitled to receive a written Good Faith Estimate within 3 business days after scheduling.

You may also request a Good Faith Estimate from any health care provider or facility before receiving services.

If you receive a bill that is $400 or more above your Good Faith Estimate, you have the right to dispute the bill.

Be sure to save a copy of your Good Faith Estimate for your records.

Questions or More Information

For more information about your rights under the No Surprises Act or your right to a Good Faith Estimate, visit: