Good Faith Estimate

Right to Receive a Good Faith Estimate of Expected Charges Under the No

Surprises Act

Under the new regulations implemented as part of 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 bill for medical items and services. You have the right to receive a

Good Faith Estimate for the total expected cost of any non-emergency items or

services. This includes related costs like medical tests, prescription drugs, equipment,

and hospital fees. 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 healthcare provider, and any other provider you choose, 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, visit https://www.cms.gov/nosurprises or call 1-800-985-3059