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Your Rights and Protections Against Surprise Medical Bills and Balance Billing
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is 'balance billing' (sometimes called 'surprise billing')?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isnt in your health plans network.
'Out-of-network' describes providers and facilities that havent signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called 'balance billing.' This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
'Surprise billing' is an unexpected balance bill. This can happen when you cant control who is involved in your carelike when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
Insurers are required to tell you, via their websites or on request, which providers, hospitals, and facilities are in their networks. Hospitals, surgical facilities, and providers must tell you which provider networks they participate... Read More
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