February 10, 2022
I hope that you and your loved ones are enjoying a great start to the new year. And while I also hope that none of us need any serious medical care, I want you to know that starting in 2022 you will no longer be hit with a big "surprise" bill if you inadvertently receive care that is "out of network."
The No Surprises Act = Important Financial Protection
For routine care that you can plan ahead of time, you always want to choose a doctor and facility that is part of your health insurance provider's network.
But under the new law, if you need emergency care and you end up at a hospital or urgent care facility that is out-of-network, you will be billed as if it were in-network. That can save you a lot of money.
Moreover, if you choose to use an in-network facility, but somewhere during your care, an out-of-network doctor gets involved in your case, that doctor can't charge you more than you would be responsible for if they were in-network.
This is such an important protection. For years, many people who carefully confirmed their doctor and a facility were in-network, got the nasty surprise of a big bill charged by out-of-network doctors such as anesthesiologists.
If you want to work with a specialist who is out-of-network, you must give signed consent that you will pay the difference between what your insurer covers and the remaining balance. This is known as balance billing.
There is one area where surprise bills might pop up. The new federal law does not cover ground ambulances (but does cover air ambulances). It's up to each state to decide on any protections for out-of-network ambulance transport.
While there will be no ugly surprise billing to worry about, I want to be clear that you are still responsible for any deductible, copays, or co-insurance charged by your insurer.
And those expenses can add up. I think it's so smart to check what your maximum out-of-pocket costs can be for the year. Depending on your plan, that can be more than a few thousand dollars, and it can hit you all in the same month (or two). That's another reason why I want you to protect yourself with an emergency savings fund.