Specific Situations
Out-of-Network Medical Bill - What To Do
Out-of-network bills are the most expensive type of medical bill, but you may have more protections than you think.
Updated August 17, 2026 · 7 min read
Quick answer
If you receive an out-of-network bill, check whether the No Surprises Act protects you. For emergency services and certain non-emergency services at in-network facilities, you are protected. For other out-of-network care, negotiate the bill and research your state protections.
When the No Surprises Act Protects You
The No Surprises Act protects you from balance billing in these situations: emergency services from any provider, non-emergency services at in-network facilities from out-of-network providers, and air ambulance services from out-of-network providers.
When You May Not Be Protected
The No Surprises Act does not cover: ground ambulance, fully out-of-network elective care where you signed a consent form, or services at an out-of-network facility. In these cases, you may owe the full out-of-network amount.
Negotiate the Bill
Even without No Surprises Act protection, you can negotiate. Ask what an in-network patient would pay, request a prompt-pay discount, and explore financial assistance. Many out-of-network providers will reduce the bill to avoid collections.
Check State Protections
Many states have their own surprise billing laws that provide protections beyond the federal No Surprises Act. Research your state laws or contact your state insurance commissioner.
What the research says
The No Surprises Act protects patients from out-of-network balance billing for emergency services.
Frequently asked questions
Can I negotiate an out-of-network bill?
Yes. Out-of-network providers may be more willing to negotiate because they risk receiving nothing if the bill goes to collections.
What if I did not know the provider was out-of-network?
The No Surprises Act may protect you if the service was at an in-network facility. If not, you can still negotiate and check state protections.
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