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The No Surprises Act protects patients from surprise medical bills when you can't control who is involved in your care, such as emergency services or getting treated by an out-of-network provider at an in-network hospital or ambulatory surgical center.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

The Act requires a good faith estimate (GFE) to be provided to all uninsured patients and should include all services expected to be provided by both primary and co-providers. HHS recognized that providing the GFE would involve coordination between the primary and co-providers.

Non-Covered Services: Some medical services or prescription medications may not be covered by your insurance plan. If this is the case, you will be responsible for the full cost of the service or medication, which may exceed your copayment.

Surprise out-of-network bills arise when a consumer receives care from an out-of-network provider in a situation she cannot reasonably control, such as being treated by an out-of-network anesthesiologist at an in-network hospital.

The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.

This is known as balance billing. An unexpected balance bill is called a surprise bill. The Consolidated Appropriations Act of 2021 was enacted on December 27, 2020 and contains many provisions to help protect consumers from surprise bills, including the No Surprises Act under title I and Transparency under title II.

Since the beginning of his Administration, President Biden has passed historic legislation to lower health care costs for tens of millions of Americans, took on Big Pharma to finally allow Medicare to negotiate lower prescription drug prices, and took action to eliminate hidden fees in every sector of the economy.