Ending Surprise Medical Bills

See how new rules help protect people from surprise medical bills and remove consumers from payment disputes between a provider or health care facility and their health plan.

What is the “No Suprises Act”?

The “No Surprises Act” was created to protect people from surprise medical bills. According to the Centers for Medicaid and Medicare Services (CMS), “As of January 1, 2022, consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.” This restricts “excessive” out-of-pocket costs at these facilities.

What Can You Expect?

Whether your insurance is private or through your job, you should not receive a surprise bill for “emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers,” says the CMS.

The new rules under the act include: 

  • The ban of surprise bills “for emergency services, even if you get them out-of-network and without approval beforehand (prior authorization).” 
  • No more out-of-network cost-sharing for emergency and some non-emergency services (this means out-of-network coinsurance or copayments).
  • “Ban out-of-network charges and balance bills for supplemental care (like anesthesiology or radiology) by out-of-network providers who work at an in-network facility.” 
  • Healthcare providers and facilities are now required to give you a notice in easy-to-understand language about how receiving out-of-network care can be more costly and options to avoid balance bills (also called a surprise bill). You don’t have to sign this notice. 

What if I don’t have health insurance or choose to pay for care on my own without using my health insurance?

According to CMS, “if you don’t have insurance or you choose to pay for care without using your insurance (also known as “self-paying” for care), these new rules make sure you can get a “good faith estimate” of how much your care will cost, before you get care.”

Good News for Health Consumers

Since we’re all consumers of healthcare, this is good news for all of us! Now that the “No Surprises Act” is in effect, this is one less barrier for people when it comes to accessing healthcare. For more information or what to expect head to: https://www.cms.gov/nosurprises

No Surprises with 9Health:365

At 9Health: 365, we pride ourselves on the fact that we’ve always operated this way. All our preventive health screenings are affordable and pricing is listed upfront. You don’t need a doctor’s referral, and you don’t need health insurance. You choose the screenings that are right for you and take your results to your doctor at your next visit. 

Some of our most popular screenings include a Blood Chemistry and a Hemoglobin A1c (diabetes) screening.

You can get any of our screenings through our partnership with Quest Diagnostics. You can also attend one of our 9Health Fairs. Our spring season is just around the corner, and we’ll be announcing dates and locations soon.