How ACA Protects You From Surprise Medical Bills

If you’ve ever received a surprise medical bill, you know how frustrating and stressful it can be. These bills often come from out-of-network providers who charge exorbitant fees for their services. In the past, there was little you could do to protect yourself from these unexpected expenses. However, the Affordable Care Act (ACA) has included several provisions to help consumers avoid surprise medical bills.

What is a surprise medical bill?

A surprise medical bill is a bill for medical services that you received from an out-of-network provider. These bills are often unexpected and can be very expensive. You may receive a surprise medical bill if you go to an out-of-network hospital or if you see an out-of-network doctor.

How does the ACA protect you from surprise medical bills?

The ACA includes several provisions to help consumers avoid surprise medical bills. These provisions include:

– Prohibition on balance billing – Balance billing is when a provider bills you for the difference between the amount the provider charges for a service and the amount your insurance company pays. The ACA prohibits balance billing for out-of-network emergency services.
– Requirement for providers to provide a good faith estimate – Providers are required to provide you with a good faith estimate of the charges for any non-emergency services that are not covered by your insurance. This estimate must be provided before you receive the services.
– Right to appeal surprise medical bills – You have the right to appeal surprise medical bills. If you believe that you have been billed in error, you can file an appeal with your insurance company.

What should you do if you receive a surprise medical bill?

If you receive a surprise medical bill, you should take the following steps:

1. Contact your insurance company. Your insurance company may be able to help you resolve the bill.
2. Review the bill carefully. Make sure that the charges are accurate.
3. File an appeal. If you believe that you have been billed in error, you can file an appeal with your insurance company.

The ACA’s provisions on surprise medical bills are a major victory for consumers. These provisions help to protect consumers from unexpected and expensive medical bills.

Remember to seek our licensed agent help

Here are some additional resources that you may find helpful:

– [Kaiser Family Foundation: Surprise Medical Bills](https://www.kff.org/health-reform/issue-brief/surprise-medical-bills/)
– [National Consumer Law Center: Surprise Medical Bills](https://www.nclc.org/issues/surprise-medical-bills.html)