Right to Receive a Good Faith Estimate

If you do not have insurance, or you choose not to use your insurance, you have the right to receive a Good Faith Estimate (“GFE”) of your medical care costs.

Under the law, patients who don’t have insurance or choose not to use their insurance have the right to receive an estimated bill that outlines their anticipated costs for medical items and services before proceeding with medical care, known as a GFE.

A GFE provides an estimate of the total expected cost of scheduled services, including medical tests, prescription drugs, and equipment.  Actual items, services or charges may differ from the GFE due to unknown or unexpected costs that may arise during treatment as each patient’s plan of care may be different. There also may be additional items or services recommended as part of your course of care that must be scheduled or requested separately and are not reflected in the GFE.

If you wish to receive a Good Faith Estimate, be sure to:

• Schedule your medical service(s) at least three (3) business days in advance of the appointment; or
• Request a Good Faith Estimate before you schedule medical services.

Please make a copy or take a picture of your Good Faith Estimate for your records. If, after receipt of your medical service(s), you receive a bill that exceeds your Good Faith Estimate by $400 or more, you will have the opportunity to dispute the charges.

For questions or more information about your right to receive a Good Faith Estimate, visit cms.gov/NoSurprises/Consumers.