Your Rights and Protections Against Surprise Medical Bills

Share:
article-hero

The No Surprises Act* effective on January 1, 2022, establishes new federal protections against specific surprise medical bills from an out-of-network provider.

Out-of-network is a term used to describe providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service, which is called “balance billing”. Please note that the full amount is likely more than the in-network costs for the same service and might not count toward your annual out-of-pocket limit.

The No Surprises Act protects you from surprise medical bills (and balance billing) in three main scenarios:

  1. Emergency Services: When you get covered emergency services from an out-of-network provider or out-of-network emergency facility.
  2. Non-emergency Services: When you receive non-emergency services from an out-of-network provider delivered as part of a visit to an in-network health care facility.
  3. Air Ambulance Services: When you get covered air ambulance services provided by an out-of-network provider.

You can only be balanced billed in these scenarios if you give the provider permission to do so by signing a surprise bill protection form. Please note: You aren’t required to provide permission and shouldn’t sign the form if you didn’t choose a health care provider before scheduling care. Here’s an example of a Surprise Bill Protection form.

Please review Your Rights and Protections Against Surprise Medical Bills notice to familiarize yourself with these rights.

Receiving care from an in-network provider or facility may cost less. If you are enrolled in a GuideStone® medical plan, please call the number on the back of your ID card to find an in-network provider.

Learn more about the No Surprises Act, or if you believe you’ve been incorrectly billed, visit CMS.gov/NoSurprises.


*Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021 (CAA) amended title XXVII of the Public Health Service Act (PHS Act).

Related Articles
See All