Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who does not have insurance or who are not using insurance an estimate of the bill for medical services.

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You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services or items.  This includes related costs like medical tests, visit and procedure fees, and medications/birth control costs.
If you schedule your service three business days in advance, you will receive a Good Faith Estimate in writing at least 1 business day after you scheduled your visit.  You may also ask for a Good Faith Estimate in advance of scheduling the visit.

The Good Faith Estimate shows the estimated cost of services that are reasonably expected for your health care needs for the service. The estimate is based on information known at the time the estimate was created and based on the reason for your visit.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during your visit.  
HHS regulations establish that when the billed charges for any provider or facility are in excess of the good faith estimate for that provider or facility by $400 or more, the item or service may be eligible for payment determination by a SDR entity through the PPDR process.

 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-561-848-6402.