Medical debt remains a leading cause of personal bankruptcy in this country. One catastrophic injury or prolonged illness can leave an individual or family owing hundreds of thousands of dollars in medical bills.
What people don’t often realize is that many of the people buried in medical debt have health insurance. Depending on what kind of insurance they have, what it covers and a variety of other factors, however, it may not cover anywhere near the full cost of treatment.
In-network vs. out-of-network treatment
The difference between getting treatment from a provider in your insurance company’s network and one that’s not in the network can be significant. While most people take care to see doctors in their network for routine and planned treatment, that’s just not always possible.
For example, maybe they need to see a specialist and there are no other choices within reasonable traveling distance. Further, if is in a car crash or otherwise needs emergency care, they typically are taken to the nearest hospital.
That’s why a new federal law was enacted at the beginning of 2022. It’s called the “No Surprises Act.” The law, signed by President Joe Biden, was passed in Congress with rare bipartisan support.
What does the No Surprises Act do?
The law prohibits emergency care providers from charging more than their in-network rate, even if the patient’s insurer is out-of-network. Further, it prohibits providers from charging patients more than their insurers’ stated coverage amount for either emergency or non-emergency care.
There are also provisions that require providers to notify patients if their insurer isn’t in their network and get their written consent to out-of-network care. Further, they must provide an estimate of the cost at least 72 hours before any non-emergency treatment.
The law also offers some protections for uninsured patients or those who choose not to use their insurance. For example, providers must give them a “good faith” estimate of the cost of their services or treatment up-front.
The law is expected to save Americans some $10 million annually and help prevent unwanted surprises. However, it can’t protect them from incurring medical bills they simply can’t afford to pay. It’s also not retroactive, so it won’t make any debt owed from before 2022 (which has probably been sent to collectors) go away.
If you’re dealing with overwhelming medical debt, it’s important to determine what your best course of action is for getting out from under it and preventing it from impacting your overall financial well-being. Getting sound legal guidance can help.
