What it covers
- Emergency care: you generally cannot be balance billed for emergency services, even out-of-network, and you pay in-network cost-sharing.
- Non-emergency care at in-network facilities: out-of-network providers such as anesthesiologists or radiologists generally cannot balance bill you without your advance written consent, and some cannot ask for it at all.
- Air ambulances: out-of-network air ambulance services are covered.
Ground ambulances are not covered by the federal law, though some states have their own protections.
Good Faith Estimates for uninsured and self-pay patients
If you do not have insurance or choose not to use it, providers must give you a Good Faith Estimate for scheduled care when you book (or on request). If your bill is at least $400 more than the estimate from a provider, you can use the federal patient-provider dispute process. This is useful for planned dental and cosmetic treatment.
If you get a surprise bill
- Do not pay right away. Compare the bill with your Explanation of Benefits.
- Call the provider and your insurer and mention the No Surprises Act.
- Contact the No Surprises Help Desk (1-800-985-3059) or submit a complaint at CMS.gov.
See also medical debt and your credit report.
General information, not medical, legal or insurance advice. This post reflects the position on the date shown. Check the official sources below for the latest rules.
Last updated: 15 October 2026
