Your Right to a Good Faith Estimate

Who This Applies To

You have the right to receive a Good Faith Estimate for the total expected cost of non-emergency healthcare services if you are:

• Uninsured, or
• Insured but not planning to submit a claim to your insurance for the services

What You'll Receive

A Good Faith Estimate will include:

• The expected services
• The expected cost of those services
• Diagnosis codes, if applicable
• Provider information

The estimate is based on the information available at the time it is created. Your actual costs may differ if your treatment needs change.

When You'll Receive It

You will receive your Good Faith Estimate in writing at least:

• 1 business day before a service scheduled 3–9 business days in advance
• 3 business days before a service scheduled at least 10 business days in advance
• At any time, upon request, before scheduling

You can also request a Good Faith Estimate from any healthcare provider before scheduling services.

Your Right to Dispute a Bill

If you receive a bill that is at least $400 more than your Good Faith Estimate for a given provider, you may dispute the bill through the federal patient–provider dispute resolution process. You must start the dispute within 120 days of the date on the original bill.

For questions or to start a dispute, visit cms.gov/nosurprises or call 1-800-985-3059.

Keep Your Estimate

We recommend you save a copy of your Good Faith Estimate for your records.