All health care providers are required to give uninsured patients, those who don’t have insurance or who are not using insurance, an estimate of the amount they will be billed for scheduled items or services or upon request for other non-emergency items or services. Anyone with or without insurance may also request a good faith estimate. Request a Cost Estimate here.

If you are uninsured:

• You have the right to receive a good faith estimate of the amount you will be billed for scheduled or non-emergency items or services.  The estimate should include costs for items and services anticipated to be provided with the visit, such as medical tests and hospital fees.
• You are entitled to receive the estimate in writing at least 1 business day before your scheduled medical service or item.  You can also ask your health care provider, and any other provider you choose, for a good faith estimate before you schedule an item or service.

If you are insured, you also may request a good faith estimate of the amount you will be billed for non-emergency items and services that you might like to schedule.
Whether or not you have insurance, if the estimate you receive for the anticipated items and services substantially exceeds the amount billed to you as your responsibility, you can dispute the bill.

Please save a copy or picture of your good faith estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the No Surprises Helpdesk at 1-800-985-3059.

• Español
• عربى
• Français
• नेपाली
• Português
• 中文
• Tiếng Việt