Your No Surprises Act protections during cancer care

CMS's medical bill rights, in effect since January 1, 2022, protect patients from unexpected out-of-network medical bills.

The protections sort into two groups, and which one applies to you depends on whether you are using health insurance.

CMS describes protection from unexpected out-of-network medical bills in three settings:

• Emergency room visits. You are protected from out-of-network charges for emergency care.
• Non-emergency care linked to an in-network facility. This covers care related to a visit to an in-network hospital, hospital outpatient department, or ambulatory surgical center.
• Air ambulance services.

For people in cancer treatment, the middle item may matter most, since much care happens at hospitals, hospital outpatient departments and surgical centers. Ask your care team whether a given visit falls in one of those settings.

Uninsured patients and people paying cash get a different mechanism: information up front.

CMS states that providers must give you a good faith estimate of how much your health care will cost if you request one or schedule services at least 3 business days in advance. A good faith estimate is a list of expected charges for the items and services involved.

If the bill arrives at least $400 more than the estimate, you may be able to dispute it. CMS says an independent third party then reviews the bill and determines an appropriate payment.

Ask for the estimate in writing and keep it, so you can compare it with any bill that arrives.

It is worth being clear about the edges, because knowing them prevents unpleasant surprises:

• The insured-patient protections are described for emergency care, air ambulance, and care connected to those three types of in-network facility. Care at other settings is not described as covered by these rules.
• CMS describes these rules as protection from unexpected out-of-network bills. Ask your health plan what you still owe for covered care.

So the routine question before any new referral remains worth asking: is this place in my network, and is everyone who will treat me there in my network too?

CMS gives patients three concrete tools:

1. The help desk. 1-800-985-3059, available seven days a week, with accessibility and language support.
2. The complaint process. You can submit a complaint if you believe your facility, provider, or insurer is not following these rules.
3. The action-plan tool. You answer a few questions about your bill and CMS returns the steps that fit your situation.

The action plan tool can help when a bill has arrived and you are unsure about it.

Keep every Explanation of Benefits — the notice your health plan sends after a claim, setting out what it paid and what it says you owe. Line each new bill up against the matching notice before paying anything. When the two disagree, or when a name you do not recognize appears on a bill from an in-network hospital stay, that is the moment to call rather than to pay.

• Centers for Medicare & Medicaid Services, Medical Bill Rights and No Surprises Act consumer page, opened October 2, 2026.