Your Right to a Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost.

Under the law (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 items and services.

Your Rights as an Uninsured or Self-Pay Patient

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your provider for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, contact us at 863-282-2082 or visit www.cms.gov/nosurprises.