What the No Surprises Act means for Patients
The No Surprises Act provides protections for patients who receive health care benefits from their employers or who are enrolled in individual health plans. For services that fall into these protected categories, providers will not be allowed to bill you for amounts higher than what you would pay from an in-network provider. Any out-of-network care costs in these types of situations will be applied to your in-network deductible and your out-of-pocket max.
You are also protected from surprise billing if you need an air ambulance; again, you will only be responsible for what you would pay for a similar in-network service. It’s important to note, however, that the NSA does not protect patients from balance billing for ground ambulance services.
What the No Surprises Act Does Not Cover
In general, if a patient chooses to receive care out-of-network, The No Surprises Act will not apply.
So, if you choose to see a doctor or specialist who is not in-network, The No Surprises Act and its protections will not apply, and you may face much higher costs than your health plan’s in-network rate.
The No Surprises Act also does not protect patients from balance billing for ground ambulance services, or when the law’s notice and consent requirements are met.