Under the “No Surprises Act,” everyone who takes care of you at an emergency room will be in-network. But the law won’t help every person.
We are in year one of the federal “No Surprises Act.” The law that protects people from getting surprise medical bills went into effect in January 2022, and we’re just starting to see the effects of the new legislation.
Surprise medical bills often come up in emergencies when patients don’t have the opportunity to choose their providers and end up receiving out-of-network care, or when patients go to an in-network facility for a scheduled procedure but not every provider at the facility is in-network.
This can definitely be confusing to patients, so here’s an example:
Let’s say you go in for an emergency surgery or c-section. There are several doctors taking care of you, from anesthesiologists to radiologists, and after all is said and done, you come to find out one of them didn’t accept your insurance. Then you’re slapped with a huge bill, ranging from hundreds to tens of thousands of dollars.
But under the new law, everyone who takes care of you at an emergency room or urgent care center will be considered in-network care, and for scheduled care, you should be covered as long as the facility is in-network. The idea is that, now you wouldn’t be charged anything extra beyond what you’d normally pay under your current insurance plan.
But there are still some gaps.
While air ambulances are covered under the law, ground ambulance transportation is not. It’s a little more complicated, and Congress may circle back to it.
Studies show before this law took effect, 1 in 5 emergency room visits resulted in surprise medical bills, but the government estimates that this new act will apply to about 10 million surprise bills each year.
The law won’t necessarily help those who already received surprise bills before the law took effect.