Surprise Bills and the No Surprises Act: Your Rights
The No Surprises Act bans many out-of-network 'gotcha' bills. Here's when it protects you and exactly what to do if you get one anyway.
Since 2022, the federal No Surprises Act has protected patients from many of the most outrageous out-of-network bills. But the protections only work if you know they exist.
When you're protected
- Emergency care at any hospital, in or out of network.
- Non-emergency care at an in-network facility delivered by an out-of-network provider you didn't choose (for example, an out-of-network anesthesiologist at an in-network hospital).
- Air ambulance services.
In these cases, you can only be billed your normal in-network cost-sharing — the provider cannot balance-bill you for the rest.
When it doesn't apply
Ground ambulances are a notable gap — they are not yet covered by the Act. Some scheduled care is also exempt if you signed a consent waiver.
What to do if you get a surprise bill anyway
- Don't pay it immediately.
- Compare the bill against your EOB.
- Call your insurer and say the words "No Surprises Act" — ask them to reprocess at in-network rates.
- File a complaint at the federal No Surprises help line if the provider won't budge.
Surprise bills are one of the most winnable disputes there is. Send us the bill and we'll check whether the Act applies to your situation.
Dana is a patient-billing advocate who has reviewed thousands of hospital bills and recovered millions in overcharges for patients.
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This guide is general information, not legal, financial, or medical advice. Rules and prices vary by state, provider, and insurer; verify specifics against your own bill, your Explanation of Benefits, and the provider's billing office.