You can't be balance billed for these emergency services. If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan's in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You're protected from balance billing for: Surprise medical bills could cost thousands of dollars depending on the procedure or service. This can happen when you can't control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. "Surprise billing" is an unexpected balance bill. This is called " balance billing." This amount is likely more than in-network costs for the same service and might not count toward your plan's deductible or annual out-of-pocket limit. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. "Out-of-network" means providers and facilities that haven't signed a contract with your health plan to provide services. You may have additional costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn't in your health plan's network. When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, like a co-payment, coinsurance, or deductible. What is "balance billing" (sometimes called "surprise billing" )? In these cases, you shouldn't be charged more than your plan's co-payments, coinsurance, and/ or deductible. When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. Your Rights and Protections Against Surprise Medical Bills The portion of your bill that's your responsibility is commonly referred to as your out-of-pocket expense, which varies from person to person and depends on individual insurance policies. If you have questions about those bills, please call the telephone numbers on their statements for assistance.
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