RECEIVE A GOOD FAITH ESIMATE

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Texas Surprise Billing

Patients get surprised by medical bills if they get care outside their health plan’s network without realizing it. For example, a patient may pick a surgeon in her plan’s network, however; the patient may not be asked about the anesthesiologist. Texas state law may protect patients with state-regulated health insurance from surprise medical bills in emergencies and when they didn’t have a choice of doctors. A patient has a right to be provided: a written disclosure that confirms whether the facility is in-network based on the insurance information the patient provides; to be told that facility-based physicians may bill separately and may not participate in the patient’s insurance plan; to request a list of physicians that have been granted medical staff privileges at that facility and to request from that facility-based physician information whether the physician is in-network with the patient’s insurance plan.

For additional information, please visit the Texas Department of Insurance website or call 800-578-4677.