Good Faith Estimate

• You have the right to receive a “Good Faith Estimate” explaining how much your medical
  care will cost
• Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees
• Make sure your health care provider gives you a Good Faith Estimate in writing at least
  one business day before your medical service
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can
  dispute the bill
• Make sure to save a copy of your Good Faith Estimate
• THIS IS FOR PATIENTS WHO DO NOT HAVE INSURANCE

For questions or more information about your right to a Good Faith Estimate, visit
https://www.cms.gov/nosurprises or call 877-696-6775