Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost Under the law, healthcare providers need to give patients who don’t have certain types of healthcare coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

You will be provided with an estimate of the anticipated charges for your non-emergency care upon request. Please do not hesitate to ask for information. PPO: Blue Cross, Aetna, VA

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your 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 receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to 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/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059

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