Can Surprise Medical Bills Be Avoided? What is ACA Balance Billing Protection About?
Have you ever had an unexpected medical bill after receiving healthcare services? Did you know that, under certain circumstances, you may be protected from surprise medical bills? Let’s explore the ACA Balance Billing Protection and what it means for you.
The Affordable Care Act (ACA) includes provisions to protect consumers from surprise medical bills. Balance billing occurs when a healthcare provider bills a patient for the difference between the amount the provider charges and the amount the patient’s insurance company pays. This can result in unexpected and often unaffordable bills for patients.
The ACA’s Balance Billing Protection applies to emergency services, out-of-network services provided at in-network facilities, and air ambulance services.
Emergency Services
If you receive emergency medical services, you are generally protected from balance billing, even if you are treated by an out-of-network provider. This means that you cannot be billed for more than your in-network cost-sharing amount.
Out-of-Network Services Provided at In-Network Facilities
If you receive non-emergency services at an in-network facility, but are treated by an out-of-network provider, you may be billed for the difference between the in-network and out-of-network rates. However, the amount you are billed cannot exceed what you would have paid if the provider was in-network.
Air Ambulance Services
If you are transported by air ambulance, you may be billed for the cost of the transport. However, you cannot be billed for more than the in-network rate for the transport.
If you receive a surprise medical bill, you should contact your insurance company and the healthcare provider to dispute the bill. You may also file a complaint with the government.
To avoid surprise medical bills, it is important to understand your health insurance policy and to ask about the costs of any services you receive. You can also contact your insurance company to find out if you have any out-of-network coverage. By following these tips, you can help protect yourself from surprise medical bills.
Disclaimer: I am not a financial advisor, and this information should not be considered financial advice. If you have any questions about your specific financial situation, please consult with a licensed professional.
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