Your protections against surprise billing

Billing Disclosure Statement

You are protected from surprise medical bills, also known as balance billing, when you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center. In these situations, you cannot be charged more than your health plan’s in-network copayments, coinsurance, or deductible amounts.

Balance billing occurs when an out-of-network provider bills you for the difference between what your health plan pays and the provider’s full charge. This often results in higher costs than if you had received care from an in-network provider, and these extra amounts may not count toward your plan’s deductible or out-of-pocket limit.

Surprise billing refers to unexpected charges that arise when you are unable to choose your provider, such as during emergencies or when you are unknowingly treated by an out-of-network provider at an in-network facility. These surprise bills can be significant, depending on the services provided.

When balance billing is prohibited

Federal and Texas laws, including the No Surprises Act and Texas Senate Bill 1264, prohibit balance billing for:

• Emergency services provided by out-of-network providers or facilities. You are only responsible for your in-network cost-sharing, and you cannot be balance billed for these services unless you give written consent after you are stabilized.
• Certain services at in-network hospitals or ambulatory surgical centers, such as emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. Providers of these services cannot balance bill you and cannot require you to waive your protections.

For other services at in-network facilities, out-of-network providers may only balance bill you if you provide written consent to waive your protections.

You are never required to give up these protections or to seek care from out-of-network providers. You can always choose to use in-network providers and facilities.

What you are responsible for

When balance billing is not allowed, you are only responsible for your usual in-network cost-sharing amounts. Your health plan must cover emergency services without prior authorization, pay out-of-network providers directly, and count your payments toward your in-network deductible and out-of-pocket maximum.

If you believe you have been wrongly billed

If you believe you have been wrongly billed, you can file a complaint with your health insurer or through your state’s complaint process. For more information about your rights, visit the federal No Surprises Act website or call 1-800-985-3059.

Related pages

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Last updated: July 30, 2026