Good Faith Estimate 

If you don’t have health insurance or are not using insurance, you have the right to receive a “Good Faith Estimate” of the total expected cost of your medical care upon request or when scheduling health care services.

If you schedule a health care item or service at least 3 business days in advance, you are entitled to receive a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, you are entitled to receive a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can disputethe bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.