Your Rights and Protections Against Surprise Medical Bills
当您得到紧急护理或在网络内的医院或流动外科中心接受网络外供应商的治疗时，您可以免于结余账单。在这种情况下，你被收取的费用不应该超过你的计划的共同支付额、共同保险和/或免赔额。
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a co-payment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“网外”是指没有与你的健康计划签订合同来提供服务的供应商和机构。网络外的供应商可能被允许根据你的计划支付的费用和服务的全额费用之间的差额向你收费。这被称为“余额账单”。这个金额可能比相同服务的网络内成本更高，可能不会计入您的计划的免赔额或年度自付限额。
“意外账单”是一种意外余额账单。当你不能控制谁参与你的护理时，就会发生这种情况，比如当你有紧急情况，或者当你计划访问一个网络内的设施，但意外地由一个网络外的供应商。Surprise medical bills could cost thousands of dollars depending on the procedure or service
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
当您从网络内的医院或门诊手术中心获得服务时，某些提供商可能是网络外的。在这些情况下，这些提供商最多只能向您收取您的计划的网络内成本分摊额。这适用于急救医学、麻醉、病理学、放射学、实验室、新生儿学、助理外科医生、医院医生或重症监护服务。这些供应商不能平衡你的账单，可能不会要求你放弃你的保护不平衡账单。
If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
In addition to federal law, Minnesota law provides Minnesota residents with similar rights and protections against surprise medical bills for emergency services and unauthorized provider services provided by out-of-network health care providers.
When balance billing isn’t allowed, you also have the following protections:
- You’re only responsible for paying your share of the cost (like the co-payments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
- Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- 你欠供应商或设施(成本分摊)的金额取决于它将支付给网络供应商或设施的金额，并在你的利益解释中显示该金额。
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact the Department of Health & Human Services at1-800-985-3059. Visitwww.cms.gov/nosurprisesfor more information about your rights under federal law. If you are a Minnesota resident, you may also contact the Minnesota Department of Commerce at(651) 539-1600or1-800-657-3602获取更多关于你在明尼苏达州法律下的权利的信息。