Good faith estimate

• You have the right to a “Good faith estimate” explaining how much your medial care will cost. Under the law, health care providers provide patients an estimate of the cost for medical services or items provided. 

• This includes the total cost of any non-emergency items or services and other related costs like medical tests, prescription drugs, equipment and hospital fees. 

• Your health care provider should give you your “Good faith estimate” in writing at least 1 business day before your medical services or items are scheduled to be provided. You can ask for a good faith estimate before you schedule your service or obtain your items. 

• If you receive a bill that is at least $400 more than your good faith estimate, you can dispute it. 

• Save a copy or take a picture of your good faith estimate for your records.

• For questions or more information about your right to a good faith estimate, visit www.cms.gov/nosurprises or call us at (insert business phone number)