Your Right to Receive a
Good Faith Estimate

of Expected Charges

Effective Date: 10/05/2026

You have the right to receive a Good Faith Estimate explaining how much your health care will cost.

Under federal law, health care providers and facilities must give patients who do not have certain types of health care coverage, or who are not using certain types of health care coverage, an estimate of the expected charges for scheduled health care items and services.

Your rights include:

• You have the right to receive a Good Faith Estimate for the total expected cost of non-emergency items or services upon request or when scheduling qualifying services.

• If you schedule an item or service at least 3 business days in advance, make sure your provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling.

• If you schedule an item or service at least 10 business days in advance, make sure your provider or facility gives you 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 do, the provider or facility must give you the estimate in writing within 3 business days after you ask.

• If you receive a bill that is at least $400 more than your Good Faith Estimate from that provider or facility, you may be able to dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate and the bill.