Can I know my health care costs before I receive 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.
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 after 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.
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.
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.What should I do after I receive a medical bill?
What should I do after I receive a medical bill?
- Open your bill(s) immediately.
- Be sure you understand the charges. If you don’t, call the facility’s billing department for an explanation of anything that is confusing. Billing departments and insurance companies can make mistakes — so if something doesn’t look right, it’s good to check. Keep notes of your conversation: include the date, time, name of the person you’re speaking with, and what they tell you.
- Save all bills and documents from your provider and health insurance company, and keep them together in the same, easy-to-find place.
- Mark the due date for your first payment on your calendar to help you remember to send your payment on time. (Late fees may be charged otherwise.)
- Compare each “good faith estimate” with your final bills. If the bill is $400 or more than the “good faith estimate,” you can dispute your bill. (Learn how to dispute your bill in the section below.)
Are you unsure about a bill?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 you officially dispute a bill:
- You must file within 120 days (about 4 months) of the date of your first medical bill.
- You must submit a copy of the bill and the “good faith estimate.”
- You must pay $25 to dispute the bill. 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?
Under the No Surprises Act, your doctor or hospital is prohibited from sending your medical bills to collection agencies during the Patient-Provider Dispute Resolution period. During this time, check your credit report. If you see the medical bills from an ongoing Patient-Provider Dispute Resolution listed on your credit report, submit a complaint online to the Consumer Financial Protection Bureau or call 855-411-2372.
At the end of the Patient-Provider Dispute Resolution, if you still have an unaffordable medical bill, ask to be screened for the hospital’s financial assistance program. DO NOT sign up for a medical credit card or medical loan. (See Guide 5: I Am Unable to Pay for My Care Up Front.)
For a deeper dive: Learn more about your rights to dispute a bill.