No Suprise Act. - Blog Posts

Before you pay that not-covered hospital bill:

I want to take a min to spread awareness for the No Surprises Act after noticing a reddit post earlier.

This protection for patients just popped up in the past couple years, and the one major downside is that it's up to the patients to speak up to make use of it, but not everyone knows what it is.

"If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care up front, before your visit."

Consumer fact sheet

Typically, health insurance companies will help pay for bills from "in-network" providers, AKA their VIP inner circle gang turf. They won't help pay if you get medical care from another gang's henchmen (out of network).

This means that sometimes, a person would go to the hospital, which they knew had been covered by their insurance before, so they expect it's going to be relatively affordable. But they didn't know that multiple medical "gangs" were working in the same hospital. Their anesthesiologist, for example, was from a different gang. That specialist was out of network even though the surgeon and nurses were all in network.

Boom. Big bill for thousands of dollars and their insurance refuses to help pay it.

But now we have this law! The No Surprises Act means that insurance companies need to cover "surprise" expenses (under certain conditions).

If you don't have health insurance, hospitals and clinics need to give you an accurate quote before you get services, then foot the bill if they were too far off the mark.

The Fact Sheet section of the Centers for Medicare and Medicaid services have some wonderful user-friendly resources for you about health insurance and how this act works.

Keep in mind that Medicare and government-run programs always have weird rules for everything, so you might have different (yet similar) protections through those programs.

If you have a medical bill that wasn't covered by insurance and you think it might count as a surprise bill, please check out your rights and consider fighting it instead of letting it become a stressful expense or debt you can't repay.

Go here to start figuring things out for your situation:

Health insurance companies have way, waaaaay too much power over our lives. We need every drop of protection we can get - but it only counts as much as we can understand and use those protections!