Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-
network hospital or ambulatory surgical center, you are protected from balance
billing. In these cases, you shouldn't be charged more than your plan's copayments,
coinsurance and/or deductible.
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
(https://www.healthcare.gov/glossary/out-of-pocket-costs/), like a copayment
(https://www.healthcare.gov/glossary/co-insurance/), or deductible
(https://www.healthcare.gov/glossary/deductible/). If you see a provider or visit a healthcare facility that
isn't in your health plan's network, you may have additional costs or have to pay the entire bill.
"Out-of-network" means providers and facilities that haven't signed a contract with your health plan to
provide services. Out-of-network providers may be allowed to bill you for the difference between what
your plan pays 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 plan's
deductible or annual out-of-pocket limit.
"Surprise billing" can happen when you can't control who is involved in your care-like 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. Surprise medical bills could cost thousands of dollars depending on the procedure
+ When balance billing isn't allowed, you also have these protections: