For many patients navigating America’s health care system, expensive medical bills are expected, so it’s no surprise that nearly two out of three adults in the U.S. are concerned about additional health care costs that have They don’t know about. One in three Americans reported being “very concerned” about these surprising medical costs. According to a 2020 Harris Poll survey from the American Heart Association, the financial implications of health care prevented nearly half of respondents from receiving medical care.
This concern is not unfounded. Thirty percent of adults with health insurance have received an unexpected medical bill within the past two years, according to a 2020 analysis by the Kaiser Family Foundation. This means that a patient was billed in whole or in part for care they believed was covered by their insurance. Emergency scenarios such as calling an ambulance or landing in the ER can result in sudden medical bills when providers are outside the patient’s insurance network. Although these unexpected costs vary, the average can range from $750 to $2,600.
To tackle the financial burden of unforeseen medical bills, the No Surprise Act was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act 2021. This law protects insured consumers from sudden medical bills seeking emergency care—with the exception of off-network, ground ambulance services. It also prohibits sudden billing for more regular services from out-of-network providers at in-network facilities.
Sidecar Health compiled a list of facts about surprising medical bills, and what the No Surprise Act — which took effect January 1 — will do to combat unexpected health care bills. The information comes primarily from the Center for Medicare and Medicaid Services, the primary regulatory agency behind the No Surprise Act.