我松了一口气! Congress Acts Against Surprise Medical Bills

If you have ever been caught off-guard by a large medical bill, a long-running practice known as balance billing might be the reason. A balance bill — which is the difference between an out-of-network provider’s normal charges for a service and a lower rate reimbursed by insurance — can amount to thousands of dollars.



Many consumers are already aware that it usually costs less to seek care from in-network health providers, but that’s not always possible in an emergency. 更复杂的情况, some hospitals and urgent-care facilities rely on physicians, 救护车, 和实验室 that are not in the same network. 事实上, a recent survey found that 18% of emergency room visits resulted in at least one surprise bill.1

即将到来:全面保护

The No Surprises Act was included in the omnibus spending bill enacted by the federal government at the end of 2020. The new rules will help ensure that consumers do not receive unexpected bills from out-of-network providers they didn’t choose or had no control over. 新法律将于2022年生效, patients will not receive balance bills for emergency care, or for nonemergency care at in-network hospitals, when they are unknowingly treated by out-of-network providers. (A few states already have laws that prevent balance billing unless the patient agrees to costlier out-of-network care ahead of time.)

Patients will be responsible only for the deductibles and copayment amounts that they would owe under the in-network terms of their insurance plans. 而不是向病人收费, health providers will negotiate a fair price with insurers (and settle disputes with arbitration). This change applies to doctors, hospitals, and air 救护车 — but not ground 救护车.

同意支付更多费用

Some patients purposely seek care from out-of-network health providers, such as a trusted family physician or a highly regarded specialist, when they believe the quality of care is worth the extra cost. In these nonemergency situations, physicians can still balance bill their patients. 然而, a good-faith cost estimate must be provided, and a consent form must be signed by the patient, 治疗前至少72小时. Some types of providers are barred from seeking consent to balance bill for their services, 包括麻醉医师, 放射科医生, 病理学家, 新生儿学专家, 助理外科医生, 和实验室.


谁害怕高昂的医疗费用? 大多数人

Percent of surveyed adults who say they are worried about being able to afford the following 
为了他们自己和家人

Percent of surveyed adults who say they are worried about paying for the following: Unexpected medical bills - 67%; health insurance deductible - 53%; gasoline and transportation costs - 46%; monthly utilities bills (e.g. electric or heat); prescription drug costs - 44%; monthly health insurance premium - 42%; rent or mortgage - 41%; food - 36%.Source: Kaiser Family Foundation and JAMA, 2020


巨额账单还会不断出现

The fact that millions of consumers could be saved from surprise medical bills is something to celebrate. 仍然, many people may struggle to cover their out-of-pocket health expenses, 在某些情况下是因为他们没有保险, or simply due to high plan deductibles or rising costs in general. Covered workers enrolled in family coverage contributed $5,588, 平均, 2020年的保费成本, 免赔额从2美元起,700美元到4美元以上,500, 这取决于计划的类型.2

When arranging nonemergency surgery or other costly treatment, you may want to take your time choosing a doctor and a facility because charges can vary widely. Don’t hesitate to ask for detailed estimates and try to negotiate a better price.

If you receive a bill that is higher than expected, don’t assume it is set in stone. 仔细检查医院账单是否有错误, 检查计费代码, and dispute charges that you think insurance should cover. If all else fails, offer to settle your account at a discount.