The No Surprise Act and Your Right to a Good Faith Estimate

If you don’t have health insurance or you plan to pay for health care bills yourself, generally, health care providers and facilities must give you an estimate of expected charges when you schedule an appointment or if you ask for an estimate. This is called a “good faith estimate.” A good faith estimate isn’t a bill. The good faith estimate shows the list of expected charges for items or services from your provider or facility. Because the good faith estimate is based on information known at the time your provider or facility creates the estimate, it won’t include any unknown or unexpected costs that may be added during your treatment. Generally, the good faith estimate must include expected charges for:

• The primary item or service

• Any other items or services you’re reasonably expected to get as part of the primary item or service for that period of care.

Providers and facilities must give you the good faith estimate:

• After you schedule a health care item or service.

• That includes a list of each item or service (with the provider or facility), and specific details, like the health care service code.

• In a way that’s accessible to you, like in large print, Braille, audio files, or other forms of communication.

• Providers and facilities must also explain the good faith estimate to you over the phone or in person if you ask, then follow up with a written (paper or electronic) estimate, per your preferred form of communication.

To Learn more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1.800.985.3059.