The No Surprises Act, in plain English

The No Surprises Act (42 U.S.C. § 300gg-111), in effect since January 2022, targets one specific unfairness: getting a huge out-of-network bill for care you couldn't reasonably choose the provider for.

What it covers

• Emergency services.You can't be balance-billed beyond your in-network cost-sharing for emergency care, even at an out-of-network facility.
• Out-of-network providers at in-network facilities. The anesthesiologist, radiologist, or assistant surgeon you never picked can't surprise-bill you.
• Air ambulance from out-of-network providers.

What “balance billing” means

Balance billing is when a provider bills you for the gap between what they charged and what your insurer paid. For covered situations above, that gap is now the provider and insurer's problem to settle between themselves, not yours.

If you're uninsured or self-pay

You're entitled to a Good Faith Estimate before scheduled care. If the final bill is at least $400 over that estimate, you can dispute it through the federal patient-provider dispute resolution process.

What it doesn't cover

It isn't a cap on all medical prices. It doesn't cover ground ambulances (a known gap), and it doesn't erase legitimate in-network cost-sharing. It targets surprise out-of-network charges specifically.