Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. If you do not have insurance or are not using insurance, you have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost.
This GFE shows the costs of items and services you can reasonably expect for your health care needs.
You have the right to receive a GFE for the total expected cost of any non-emergency items or services.
The GFE does not include any unknown or unexpected costs that may arise during treatment. You may experience additional charges if complications or exceptional circumstances occur.
Health care providers are required to provide a GFE within the following timeframes:
- If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;
- If the service is scheduled at least ten business days before the appointment date, no later than three business days after the date of schedule;
- If the uninsured or self-pay client requests a GFE (without scheduling the service), no later than three business days after the date of the request. Healthcare providers must supply a new GFE within the specified timeframes if the patient reschedules the requested item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Note: A GFE is for your awareness only and does not require immediate financial commitment or payment.
For questions or more information about your right to a GFE or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this GFE in a safe place or take pictures of it. You may need it if you receive a bill in a higher amount.
If you have questions or concerns, please reach out to our Member Support team.
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