Learn About Health Insurance Consumer Rights and the No Surprises Act with MD Insurance Administration – Conduit Street - Conduit Street

Join the Maryland Insurance Administration for an informative presentation to learn about a new federal law – the No Surprises Act.

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing because of the No Surprises Act.

According to the Maryland Attorney General’s Office, “surprise billing” and “balance billing” are defined as follows:

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other 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.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

During the Maryland Insurance Administration’s presentation, you will learn what you can do if you receive an unexpected balance bill after you receive emergency care from an out-of-network provider, or from an out-of-network provider at an in-network facility, such as a hospital.