Medical debt is a major problem in the United States. It’s one of the main things keeping many of our clients at Buttafuoco & Associates from getting their lives back on track after a major accident. In fact, 6% of adults in the United States owe over $1,000 in medical bills, while 1% of adults (3 million people) owe more than $10,000. This kind of debt can be devastating, leading many people to be denied essential medical care.
The Affordable Care Act has helped curb these issues by making insurance more accessible, affordable, and comprehensive while expanding Medicaid. Many millions of Americans have health insurance thanks to the ACA. However, even under the ACA, medical debt kept many of those most vulnerable—the poor and those with chronic diseases—to delay or forgo care entirely.
Even if you have coverage, have you ever gotten a bill months later for hundreds, even thousands of dollars for treatment you thought was covered? This is called a surprise medical bill. What you may not know, however, is that according to our Northern New Jersey health insurance attorneys, you may have some legal protections.
If you have received a surprise medical bill, call 1-800-NOW-HURT. Our attorneys can tell you more about your rights.
What is a Surprise Medical Bill?
A surprise medical bill often catches you off guard when you receive services from a healthcare provider or facility that isn’t in your insurance network. This means that the provider hasn’t agreed on a payment rate with your insurance company. As a result, your insurance may cover only part of the bill, leaving you responsible for paying the remaining amount. This is known as “balance billing.”
This often happens with services like anesthesia or lab tests, and you might not realize the provider or facility is out-of-network until you get the bill. Very few people know every part of their insurance policy, and it’s often difficult to “shop around” for medical services, haggling over the price of a pill that might save your life.
However, the new federal law known as the No Surprises Act aims to limit these surprise medical bills and ensure that Americans get the care they need without the debt.
What is the No Surprises Act? Can the No Surprises Act Help Me?
The No Surprises Act (NSA) went into effect in January of 2022 as a measure to help protect Americans from the medical debt that’s become so common in this country. According to our health insurance attorneys in Northern New Jersey, the most important part of this law is that it sets limits on how much you can be charged for out-of-network services.
Essentially, insurance companies negotiate a price with certain healthcare providers for various services. If you receive treatments or services from those providers, your insurance company pays the agreed-upon price. These providers are “in-network.” If you visit a provider that doesn’t have a deal with your health insurer, they are “out-of-network,” and you may end up with a huge out-of-pocket bill.
The No Surprises Act, however, limits how much you can be charged by an out-of-network provider in many situations, ensuring that out-of-pocket costs will be similar to if you had gone to an in-network provider. When you make an appointment for an essential lab test or race to the emergency room after an injury, you are of course worrying about your health, not your bill.
Another important provision for those without insurance is the requirement for medical providers to give a “good faith estimate” of the cost of a medical treatment. Before the treatment, the provider must give you an estimate of the cost, and if your bill then doesn’t match up, you may have the right to dispute that bill under the law.
How Can an Attorney Help Me With My Medical Debt?
At Buttafuoco & Associates, we understand the stress and uncertainty that medical debt can bring. Our experienced health insurance lawyers serving Northern New Jersey can help you negotiate with healthcare providers and insurance companies and make sure your rights are protected.
If you’ve received a surprise medical bill, the No Surprises Act gives you the tools to fight back. Call 1-800-NOW-HURT for a free consultation.
