Your rights under the No Surprises Act and good faith estimates

US patients · Last checked: 2026-10-25

Not legal or financial advice. This is general information for US patients, summarized from the official sources listed below. Rules vary by state and by situation, and they change. For advice about your case, talk to a lawyer, your state's consumer assistance program, or the official help lines named here. Last checked: 2026-10-25.

The No Surprises Act is a federal law that took effect January 1, 2022.

If you use health insurance

CMS says it applies to most types of health insurance and protects you from unexpected out-of-network bills for:

Emergency room visits
Non-emergency care related to a visit to an in-network hospital, hospital outpatient department or ambulatory surgical center
Air ambulance services

If you got an out-of-network bill for one of these, paid more than in-network rates, or your provider didn't follow the notice-and-consent rules, CMS says to submit a complaint (for care on or after January 1, 2022). If your insurer denied a claim and you think that breaks the law, appeal through your plan. CMS notes an unmet deductible is not a violation.

If you don't have or don't use insurance: good faith estimates

Usually, providers must give you a good faith estimate if you ask for one or schedule care at least 3 business days ahead.
Scheduled 3–9 business days ahead: the estimate is due within 1 business day. Scheduled 10+ business days ahead: within 3 business days. Asking before scheduling: within 3 business days.
It must list expected items and services with charges, and come on paper or by email, as you prefer.
Each estimate covers one provider or facility, so for surgery you may need one from the surgeon and one from the hospital.
No estimate applies to care in an emergency room or care scheduled less than 3 business days ahead.

Disputing a bill that's $400+ over the estimate

You may use the federal patient-provider dispute process if all of these apply:

You didn't have or use insurance, and told the provider so before care
Care was on or after January 1, 2022
You have the good faith estimate
The initial bill is dated within the last 120 calendar days
A provider or facility charged at least $400 more than its estimate

There is a $25 non-refundable fee. If you win, it's deducted from what you owe. While the dispute is open, the provider can't send the bill to collections or threaten to, can't collect late fees on it, and can't retaliate. Your costs won't go up because you disputed.

No Surprises Help Desk: 1-800-985-3059 (CMS lists weekdays 8am–8pm ET and weekends 10am–6pm ET).

Sources (checked 2026-10-25)

Cancel It is independent and not affiliated with any hospital, agency or organization named here.