Your rights when you get a medical bill

Plain-language overview · · not legal advice

No Surprises Act (federal, since 2022)

• For most emergency care, you generally can’t be billed more than your in-network cost-sharing, even at an out-of-network hospital or by out-of-network doctors.
• For non-emergency care at an in-network hospital or surgery center, out-of-network providers there (e.g., anesthesia, radiology) generally can’t balance-bill you unless you gave written consent in advance.
• Ground ambulance is not covered by the federal law.
• Questions or complaints: the federal No Surprises Help Desk, 1-800-985-3059, or cms.gov/nosurprises.

Good Faith Estimate (uninsured or self-pay)

• If you are uninsured or not using insurance, you can ask the provider for a written Good Faith Estimate before scheduled care.
• If the final bill is at least $400 more than the estimate from that provider, you may be able to use the federal patient-provider dispute resolution process. You generally must start within 120 days of the bill. Keep a copy of the estimate.

Financial assistance / charity care in Minnesota

• Nonprofit hospitals must have a written financial assistance policy and must limit charges for people who qualify. Ask billing for the policy and application — even after you receive a bill.
• Check whether you qualify for Medical Assistance or MinnesotaCare through MNsure; coverage can sometimes apply to recent past bills.
• The Minnesota Attorney General’s office has consumer help on medical billing and debt: ag.state.mn.us.

How to dispute a bill

1. Ask for an itemized bill with CPT/HCPCS codes.
2. Compare it to your insurer’s Explanation of Benefits (EOB); look for duplicates, services you didn’t receive, or out-of-network charges that may be protected.
3. Call billing, note the date and name, and ask for a hold on collections while it’s reviewed.
4. Appeal with your insurer in writing if a claim was denied.
5. Ask about financial assistance, a prompt-pay discount, or an interest-free payment plan.
6. If unresolved, contact the No Surprises Help Desk, your insurer’s grievance process, or the MN Attorney General.

Rules change and depend on your plan and situation. Verify with the official sources above.