If you are uninsured or “self-pay” (or not planning to submit your medical bills to a health insurance company), it can be helpful to know what you will be charged for your medical care.

The No Surprises Act gives patients an important tool to know what their medical costs will be before they get treatment: the “good faith estimate.” The “good faith estimate” is useful if you need to dispute your bill. 

You may also ask for the hospital’s financial assistance application and to be screened for hospital financial assistance programs or public health insurance coverage.

Quick tip: You can apply for hospital financial assistance or public coverage like Medicare or Medicaid even if the hospital thinks you won’t qualify. It’s often better to apply early so that you don’t miss any deadlines.

For help applying for hospital financial assistance, contact Dollar For.

Suzy sits on the sofa with her mother, Angelina, in an embrace. Angelina wears a yellow cardigan over a patterned long dress. Suzy wears a salmon pink sleeveless blouse. The room in warmly lit. The family overcame medical debt thanks to charity care.
Mano a Mano: Suzy's Story
Suzy’s mother, Angelina, required life-saving brain surgery — but the cost was insurmountable. Suzy was determined, and found the organization Mano a Mano, which connected her family with charity care. Today, Suzy works for Mano a Mano to help families like her own. “I know that there are thousands of others throughout the state who need access to health insurance. It is important that there is a coverage option for everyone, for all ages,” Suzy said.
What if I need emergency room care?

What if I need emergency room care?

Emergency care can be expensive, but your health is the priority. 

  • If you are experiencing a medical emergency, visit the nearest emergency room as quickly as possible — regardless of whether it is in your health insurance plan’s in-network hospital system. 
  • Almost all hospitals are required to treat patients who come to the emergency room (ER) with a medical emergency. This applies even if the patient cannot pay.  
    • Hospitals must screen each patient who comes to the emergency room to see whether the patient has an emergency medical condition. 
    • If the patient has an emergency medical condition, the hospital must offer treatment to stabilize the condition. “Stabilize” means that the condition is not likely to get materially worse from the patient’s discharge or transfer from the hospital. 
    • If a pregnant woman is having contractions and cannot be safely transferred to another facility, this is considered an emergency medical condition. In this case, the patient is “stabilized” when the baby and the placenta have been delivered. 
    • Once the person is stabilized, the hospital can discharge (release) the patient, even if they need additional non-emergency care. 
    • If you believe a hospital did not follow these requirements, you can file a complaint. 
Know your health care costs

Can I know my health care costs before I receive care?

You can always ask for an estimate of any care that is recommended. However, the hospital is only required to give you an estimate if you are thinking of scheduling care or have scheduled care at least three business days in advance. The hospital is not required to give you an estimate for emergency care. 

Ask for a “good faith estimate” and keep it in a safe place 

Providers must use a form similar to this one and provide expected costs for treatment in writing. The form must include the provider’s name and list the services included in the estimate — including the billing codes for each treatment, medication, laboratory test, or medical services. It must list a total amount and an itemized breakdown of what you will owe for each expected service and/or medical treatment. 

For example: Request a “good faith estimate” for things like a pre-surgery checkup or post-surgery physical therapy. Also ask if the surgeon’s estimate includes the cost of the anesthesia and the anesthesiologist. If it does not, ask for that cost information as well. 

Quick tip: You will likely need to ask for a separate “good faith estimate” from each doctor and each health care facility to better understand the entirety of expenses related to your care. A “good faith estimate” is not a contract and does not obligate you to use those doctors and/or hospitals.

Providers must provide a “good faith estimate” within a certain amount of time

If you do not have insurance or are “self-pay,” you can ask your doctors and hospitals for a “good faith estimate” at any time — even if you aren’t ready to schedule your treatment. 

If you request a “good faith estimate,” your provider must provide one, in writing, within three business days of your request. Getting a “good faith estimate” is one way to shop around for costs from different providers. If you delay your care for more than a month, check back in with that provider to make sure the “good faith estimate” is still accurate. 

When you are ready to schedule care, doctors and hospitals must provide a “good faith estimate” in writing:

  • Within one business day: if the care scheduled is within the next three to nine days.
  • Within three business days: if the care scheduled is at least 10 days in advance.

Quick tip: Check to make sure your “good faith estimate” contains your name and address, your provider’s name and address, billing codes, and a plain-language explanation of the treatment and estimated price you are expected to pay. If your provider uses your online portal to provide this estimate, take a screenshot and file it in your records. Make sure the screenshot shows your name and the provider’s name.

Were you denied a “good faith estimate”?

If you do not receive the “good faith estimate” that you are entitled to by law, contact the No Surprises Help Desk online or call 1-800-985-3059.

Quick tip: In Colorado at least, a violation of the good faith estimate requirement is a deceptive trade practice, and the patient may be able to sue. In addition, a Colorado hospital may not pursue a collection action if the hospital was not in “material compliance” with federal price transparency requirements. Find a consumer attorney for assistance.

How do I dispute bills that are $400 or more than the “good faith estimate”?

How do I dispute bills that are $400 or more than the “good faith estimate”?

Start by contacting the doctor or hospital to notify them that they have sent you a bill that is $400 or more than the “good faith estimate.” Then ask them to adjust the bill to the amount in the “good faith estimate.”

If the provider does not lower the bill, you have a right to dispute your bill through the “Patient-Provider Dispute Resolution.” Here are some additional tips to understand whether you can dispute your bill. 

To dispute a bill based on the “good faith estimate”:

  • File (online or by mail) your “good faith estimate” dispute within 120 days (about 4 months) of the date of your first medical bill. 
  • Submit a copy of the bill and the “good faith estimate.” 
  • Pay the $25 fee to dispute the bill through the dispute system. You can pay using a credit card, PayPal, or Venmo. If you win the dispute, this fee will be returned to you as a $25 credit toward your medical bill. 

How do I “officially” dispute my bill based on the “good faith estimate”?

Don’t delay. You may start a dispute online or by mail or fax. Once you do so, you have entered what’s called the “Patient-Provider Dispute Resolution” period.

Under the No Surprises Act, your doctor or hospital is prohibited from sending your medical bills to collection agencies while you are disputing your bill. If you are contacted by a debt collector during this time, file a complaint with the Consumer Financial Protection Bureau.  

Remember that you can apply for hospital financial assistance (whether or not you received a good faith estimate). If you would like help applying for financial assistance, contact Dollar For. We DO NOT recommend that patients sign up for a medical credit card or medical loan — these options can add more costs to your final bill if you are late with your payments or miss a payment deadline.

For a deeper dive

Learn more about your rights to dispute a bill that is higher than the good faith estimate.

For information on other billing disputes, see Guide 4: I received a medical bill I cannot afford.

Know Your Rights in Medical Billing

I Have Health Insurance and Need Emergency Care

In emergency situations, you often don’t choose the ambulance or the hospital. You have legal protections against emergency room, out-of-network surprise medical bills — which are described below.

Get started

I Have Health Insurance and Need to Schedule Hospital Care

Health care can be expensive. When you have health insurance and need to schedule hospital care, there are some things you can do to lower the amount that you will have to pay out-of-pocket.

Get started

I Am Uninsured and Need Medical Care

If you are uninsured or “self-pay” (or not planning to submit your medical bills to a health insurance company), it can be helpful to know what you will be charged for your medical care.

Get started

I Received a Medical Bill I Cannot Afford to Pay

Whether you are insured or uninsured, medical bills can be expensive and surprising. This guide explains how to ensure the bill is correct and what to do if you cannot afford to pay it.

Get started

I Am Unable to Pay for My Care Up Front

Negotiate with your health care provider to lower the amount you have to pay for your bill upfront or overall. Patient advocate departments at hospitals or community organizations can help you apply for financial assistance programs, set up a no-interest repayment plan, or reduce your bill.

Get started

My Unpaid Medical Bill Was Sent to Collection Agency

If you don’t pay your medical bill, the provider can sue you for payment or sell your debt to a collection company. If you fail to pay your bills, it can also hurt your credit score. However, some states have laws that prohibit health care providers from using certain collection practices against patients to collect unpaid medical bills. 

Get started

Community Stories

Waiting for the Bill: Kaylynn’s Story (Opens in a new tab) Kaylynn, who has long, wavy light brown hair. leans against a wall with gray siding. She is one of tens of millions of Americans faced with medical debt. Kaylynn

Waiting for the Bill: Kaylynn’s Story (Opens in new window)

Planting Seeds for Change: SOWEGA Rising (Opens in a new tab) Sherrell Byrd, Founder & Executive Director of SOWEGA Rising, which builds community power in southwest Georgia. Sherrell started the non-profit after her experience with medical debt.. Sherrell

Planting Seeds for Change: SOWEGA Rising (Opens in new window)

Between Life and Debt: Aracely’s Story (Opens in a new tab) Aracely is standing in their home next to a chair, wearing a dark teal button-down blouse with rolled up sleeves to reveal a delicate tattoo that covers most of their right forearm. Kitchen cabinets and a countertop, and a collection of art in black frames on a wall, are in the background. Aracely, who wears large, light gray glasses, has dark, shoulder-length hair and wears a black-knotted headscarf that covers part of their head. Aracely has a slight smile with a closed mouth. Aracely

Between Life and Debt: Aracely’s Story (Opens in new window)