For many patients navigating America’s health care system, costly medical bills are expected, so it’s no surprise that roughly two in three adults in the U.S. worry about additional health care costs that they don’t know about. One in three Americans reported being “very worried” about incurring these surprise medical costs. The financial implications of health care kept nearly half of respondents from seeking medical care, according to a 2020 Harris Poll survey completed on behalf of the American Heart Association.
This worry is not unfounded. Thirty percent of adults with health insurance received an unexpected medical bill within the last two years, according to a 2020 analysis by the Kaiser Family Foundation. This means a patient was fully or partially billed for care they believed was covered by their insurance. Emergency scenarios like calling an ambulance or landing in the ER can result in surprise medical bills when the providers are outside a patient’s insurance network. While these unexpected costs vary, the average can range from $750 to $2,600.
To combat the financial burden of unexpected medical bills, the No Surprises Act was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act of 2021. This legislation protects insured consumers against surprise medical bills when they seek emergency care out-of-network, with the exception of ground ambulance services. It also bans surprise billing for more routine services from out-of-network providers at in-network facilities.
Sidecar Health compiled a list of facts about surprise medical bills, and what the No Surprises Act—which took effect Jan. 1—will do to combat unexpected health care bills. The information primarily comes from the Centers for Medicare & Medicaid Services, the primary regulatory agency behind the No Surprises Act.