No Surprises Act Could Help Prevent Medical Debt



Health costs can be quite high even for people with health insurance. Sometimes these costs can be a nasty surprise.

It is not uncommon to seek treatment in a hospital or network facility, only to find that one of the doctors who treated you is out of the network, forcing you to pay this bill instead of having it covered by your insurance company. In fact, these events are so common that Americans regularly find themselves in medical debt due to unforeseen bills. This debt can even lead some consumers to bankruptcy, with its share of negative consequences.

A new rule aims to curb this practice. Once it goes into effect, consumers may not fall victim to surprise medical bills as often.

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Eliminate a key source of financial stress

When patients can plan for medical care in advance, it is easier to avoid a scenario where an off-grid provider must be used. But patients don’t have that luxury in an emergency. Rather, they are taken to the nearest emergency room and are treated by whoever is available.

This is where so many people get into trouble. An estimated 20% of emergency care requests from private insurers include an off-grid component, reports the Kaiser Family Foundation. While some insurance companies provide some coverage for off-grid providers, it’s also common for patients to end up having to pay the full off-grid bill on their own.

The No Surprises Act seeks to make this practice a thing of the past. From 2022, there will be few situations in which a patient can be billed for out-of-network care that they believe would be covered by their insurance company. This new rule should especially benefit emergency patients who don’t have the time or luxury to dig up the details of every provider they come across.

The No Surprises Law also requires insurance companies to provide patients with coverage for at least 90 days if a network provider leaves the network. This way, patients do not have to change providers immediately if such a change occurs while they are in the middle of a treatment plan.

Now the No Surprises Act has its limits. Patients can still be billed for out-of-network care if they visit an emergency care clinic for non-emergency purposes. In addition, if consumers are informed that the care they are about to receive is off-grid and they give their written consent to proceed, they may be billed for that care even after the news is received. rule entered into force.

A positive trend in medical bills

When surprise medical bills arise, consumers are often forced to put these charges on their credit cards and pay them off over time. The result? High interest charges and high balances which can lead to a significant reduction in a person’s credit rating.

The No Surprises Act is expected to help save consumers from the surprise medical bills that have long taken their toll on their finances. Consumers should also learn about the No Surprises law in order to know what protections they are entitled to from 2022.

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