Emergency Services:
• You can’t be balance billed for emergency services, even from out-of-network providers. You’re only responsible for
in-network cost-sharing amounts (co-payments, coinsurance, deductibles).
• This protection extends to services received after you are stabilized unless you waive your protection by giving written
consent.
Services at In-Network Hospitals or Surgical Centers:
• Certain providers at in-network facilities may be out-of-network. In these cases, they can only bill you for in-network
cost-sharing amounts.
• This protection covers emergency medicine, anesthesia, pathology, radiology, laboratory work, neonatology, assistant
surgeons, hospitalists, or intensivists.
• For other services, out-of-network providers can only balance bill you with your written consent.
Your Rights:
• You are never required to waive your protections against balance billing.
• You can always choose a provider or facility within your plan’s network.
When Balance Billing Is Prohibited:
• You’re only responsible for in-network cost-sharing.
• Your health plan pays out-of-network providers and facilities directly for any extra costs.
• Emergency services are covered without prior authorization, even if provided out-of-network.
• Payments for emergency or out-of-network services count toward your in-network deductible and out-of-pocket limits.
If you believe you’ve been wrongly billed, contact 1-800-985-3059.
For more information, visit the Centers for Medicare and Medicaid Services website.