The ColoHealth Health & Wealth Newsletter
March 2026
Vol. 29, Issue 3
Your Rights Under the No Surprises Act: How to Fight Back Against Unexpected Medical Bills
Most people don’t know they have a federal law protecting them from certain unexpected medical bills.
The No Surprises Act has been in effect since January 1, 2022 — yet four years later, millions of Americans are still paying bills they legally don’t owe.
With tax season here and year-start medical events fresh in the rearview mirror, March is the perfect time to learn exactly what this law does for you.
What the No Surprises Act Actually Does
It bans balance billing in three key situations.
If you’re covered by private health insurance, whether through your employer or the individual market, you cannot be billed more than your in-network cost-sharing amount when: you receive emergency care from an out-of-network provider or facility; an out-of-network provider treats you at an in-network hospital or surgery center (think: an anesthesiologist or radiologist you never chose); or you use air ambulance transport from an out-of-network provider.
This is big. Before 2022, a single surgery at an in-network hospital could leave you with a five-figure bill from an out-of-network anesthesiologist you never met. Studies found this happened in as many as 1 in 5 emergency room visits. That practice is now prohibited.
Tip: If you receive a surprise bill from a provider you didn’t choose, do not pay it before verifying whether the No Surprises Act applies. Contact your health plan’s member services first.
Your Good Faith Estimate Right (Even Without Insurance)
This protection applies whether you have health insurance, a health sharing plan, or nothing at all.
Providers are required by law to give you a Good Faith Estimate before your care.
This written estimate must detail expected costs for the scheduled service and any reasonably expected associated charges.
Here’s the powerful part: if the final bill exceeds the Good Faith Estimate by more than $400, you have the right to dispute it.
You can initiate a dispute through CMS’s patient-provider resolution process within 120 days of receiving the bill.
Health sharing members, take note. Because health sharing plans are not traditional insurance, members are typically treated as self-pay patients, which means the Good Faith Estimate requirement applies to you.
Always request your written estimate before receiving any scheduled service. This is one of the most underused consumer protections available to health sharing members.
For complete information on your rights, visit the official CMS No Surprises Act resource page at cms.gov/nosurprises.
What to Do If You’re Wrongly Billed
Don’t just assume the bill is correct.
- Contact your health plan. Ask whether the service is subject to the “No Surprises Act” protections. Your plan is required to apply in-network cost-sharing to covered surprise bills.
- Request an itemized bill. Go line by line, confirm every charge reflects a service you actually received, and question any unfamiliar codes.
- File a complaint if needed. If a provider violates the law, call the CMS No Surprises Help Desk at 1-800-985-3059 (8 a.m.–8 p.m. EST, seven days a week) or submit a complaint online through CMS. As of early 2025, CMS had resolved more than 16,000 complaints totaling $11.3 million in restitution for consumers.
Tip: Never let a disputed bill go to collections before the dispute is resolved. Providers cannot legally move a disputed bill into collections while an official dispute is pending.
Important Limitations to Know
The No Surprises Act does not cover every situation.
Ground ambulance transport is currently excluded from federal protections.
Many emergency ground ambulance rides still result in potential out-of-network bills — an ongoing gap that Congress has yet to close.
As of early 2026, 21 states have enacted their own ground ambulance protections, with more considering legislation, so it’s worth checking your state’s rules.
Several states have enacted their own ground ambulance protections, so it’s worth checking your state’s rules.
The law also does not apply when you knowingly choose an out-of-network provider for a non-emergency service.
In that case, you may be asked to sign a notice and consent form waiving your protections. Read any such form carefully before signing.
Steps to Take Right Now
Tax season is a good time to pull out any medical bills from January or February and review them with fresh eyes.
✔ Compare any recent bills against your Explanation of Benefits from your health plan to catch discrepancies.
✔ If you’re a health sharing member, contact your plan or your Personal Benefits Manager to understand how your plan handles bill review and negotiation. Many plans offer this as a member benefit.
✔ Request a Good Faith Estimate any time you schedule a non-emergency procedure in advance.
✔ Keep all billing paperwork and written estimates on file. Documentation is your strongest tool in any dispute.
Your Personal Benefits Manager is one of a very select group of health benefits professionals who can walk you through all your options, including how the No Surprises Act interacts with health sharing plans and other non-insurance alternatives. Consultations are always free.
Check out our latest blog posts:
- How Colorado Families Are Saving $20,000+ With Health Sharing Plans?
- What Are the Best Colorado Health Insurance Plans?
To Your Health and Wealth,
Wiley P. Long III
President- ColoHealth
Author of Health Sharing: The Authoritative Guide to America’s Fastest-Growing Health Insurance Alternative
The ColoHealth Health & Wealth Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.
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