No Surprises Act

The No Surprises Act is a law that protects you from unexpected medical bills, also called "surprise bills," especially in situations where you don’t have control over the doctors or services involved.

Here’s what it means in a nutshell:

Emergency Care:

If you end up needing emergency care (like going to the ER), you can’t be charged more just because the doctors or hospital are out-of-network. Even if the emergency care providers aren’t part of your insurance network, you only pay the same as if they were in-network.

Care at In-Network Hospitals:

If you go to a hospital or surgery center that is in your insurance network, but you end up seeing an out-of-network doctor (like an anesthesiologist or a radiologist), you can’t be charged extra for their services. You’ll only pay the regular in-network cost, not the higher out-of-network rates.

Air Ambulance:

If you're taken to the hospital by an air ambulance (helicopter or plane), you can't be charged more than the in-network rate, even if the air ambulance company isn't in your insurance network.

Good Faith Estimate

Advance Notice:

Before receiving care, if you’re going to be treated by an out-of-network provider, you must be told about it and given an estimate of how much you'll owe. If they don't inform you, you won't be stuck paying the higher, out-of-network costs.

Dispute Resolution:

If there's a disagreement about what your insurance should pay or what you owe, there’s a process to settle the issue fairly, where both sides can negotiate. If you believe you’ve been wrongly billed, contact:

The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law. 

The Michigan Department of Insurance and Financial Services at 877-999-6442 or visit “Michigan Department of Insurance and Financial Services Implements Important New Health Insurance Consumer Protections” for more information about your rights under Michigan law. 

Why Was This Law Made?

The law was created because many people were shocked by huge, unexpected bills from doctors or hospitals they didn’t even choose. It helps prevent that by making medical costs more predictable and fairer, especially in emergency situations.

So, in short, the No Surprises Act makes sure you won’t get stuck with huge, unexpected medical bills if you need emergency care or see an out-of-network doctor at an in-network hospital.

A Good Faith Estimate is an estimate of how much you might have to pay for medical services before you get them. The law says that individuals without insurance have a right to a written estimate from their healthcare provider or facility that gives them an idea of the costs for your treatment, including what they'll likely need to pay out-of-pocket.

Here’s how it works:

  • Before your appointment or treatment, the provider gives you an estimate of the costs based on your insurance plan.

  • It helps you understand how much you'll owe, so there are no surprises when the bill arrives.

The goal of a Good Faith Estimate is to make medical costs clearer and more predictable for you, so you can plan ahead.