No Surprises Act: Your Protection From Unexpected Medical Bills

What's protected:

• Emergency room visits at ANY facility — in-network or out-of-network
• You can only be charged your plan's in-network cost-sharing (copay, coinsurance, deductible)
• The emergency department cannot require prior authorization
• This protection applies from the moment you arrive until you are stabilized

After stabilization:

• Once stabilized, an out-of-network facility must give you written notice and get your consent before providing additional non-emergency services at out-of-network rates
• You have the right to refuse and request a transfer to an in-network facility

Your protection:

• Out-of-network providers at in-network facilities cannot balance bill you
• You only pay your in-network cost-sharing amount
• This applies to: anesthesiologists, radiologists, pathologists, neonatologists, assistant surgeons, and other specialists you didn't choose

Exception – written consent:

• A provider CAN bill out-of-network rates if they give you written notice at least 72 hours before the service AND you sign a consent form
• This does NOT apply to emergency services or ancillary providers — you're always protected there
• You can NEVER be asked to waive your rights for emergency care

How to use this right:

• If you receive a surprise bill for emergency services, tell the provider: "This is covered under the No Surprises Act. I should only owe my in-network cost-sharing amount."
• File a complaint at cms.gov/nosurprises or call 1-800-985-3059