Good Faith Estimate

You Have the Right to Receive a “Good Faith Estimate” Explaining How Much Your Medical Care Will Cost

Under the No Surprises Act, health care providers must give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services.

Your Rights

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.

• This includes related costs such as medical tests, prescription medications, equipment, and facility fees (if applicable).

• Your health care provider must give you a written Good Faith Estimate at least 1 business day before your scheduled service.

• You can also request a Good Faith Estimate before scheduling an appointment.

If Your Bill is Higher Than Expected

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the charges.

• Be sure to keep a copy of your Good Faith Estimate for reference.

For questions about your rights or to dispute a bill, visit www.cms.gov/nosurprises or call 800-985-3059.