Federal and Maryland laws help protect you from unexpected medical bills. These are sometimes called “surprise bills” or “balance bills.” A balance bill happens when a provider who is not in your health plan’s network bills you for more than your plan pays.

When are you protected?

In most cases, you should only have to pay what you would normally pay for in-network care (your usual copay, coinsurance, or deductible) when:

  • You get emergency care from a provider or facility outside your plan’s network
  • You are treated at an in-network hospital or surgery center by an out-of-network provider. This includes emergency doctors, anesthesia, lab work, X-rays and imaging, pathology, newborn intensive care, assistant surgeons, hospitalists, and ICU doctors.

No one can require you to give up these protections.

Maryland law gives extra protection to people in some state-regulated HMO, PPO, and EPO plans. In some cases, this includes ground ambulance rides.

 

If you don't have insurance or are paying for care yourself

If you don’t have insurance, or you choose not to use it, you usually have the right to get a written “Good Faith Estimate” of what your scheduled care should cost.

If your bill ends up $400 or higher than that estimate, you may be able to challenge it. In most cases, you need to start the federal dispute process within 120 days of getting your first bill.

 

Health Care for the Homeless

Health Care for the Homeless offers full health care and support services to people and families experiencing homelessness.

You can get care here whether or not you have insurance. We take most Medicaid and Medicare plans. If you don’t have insurance, our team can help you look into coverage and benefits you may qualify for.

As a Federally Qualified Health Center, we use a sliding fee scale, which means what you pay is based on your income and what you can afford. As federal law requires, no one is turned away because they can’t pay.

Questions about a bill from us? If you have a question about your Health Care for the Homeless bill or think it’s wrong, please reach out:

  • Health Care for the Homeless:
    Phone: 410-837-5533
    Address: 421 Fallsway, Baltimore, MD 21202
     

If you think you were billed unfairly

  • Maryland Office of the Attorney General – Health Education and Advocacy Unit
    Toll-Free: 1-877-261-8807
    Helps with problems with medical bills and insurance coverage.
  • Maryland Insurance Administration
    Toll-Free: 1-800-492-6116
    Call if you think your health plan handled your claim the wrong way.
  • Federal No Surprises Help Desk
    Phone: 1-800-985-3059
    Answers questions about your rights under the federal No Surprises Act.

  • To learn more about your rights in Maryland, visit the Maryland Attorney General's No Surprises Act page
     

This page is a summary of some of your rights under federal and Maryland law. Your exact rights depend on your health plan and the care you get.

This notice was drafted with the aid of AI and reviewed for accuracy by Health Care for the Homeless staff.