Rights and Protections Against Surprise Medical Bills

When balance billing isn't allowed, you also have the following protections:

  • You’re only responsible for paying your share of the cost (like the copayments, coinsurance and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
    • cover emergency services without requiring you to get approval for services in advance (prior authorization)
    • cover emergency services by out-of-network providers
    • base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits
    • count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit

More resources about surprise medical bills

WellSpan can help

For more information about your rights under federal law, you can visit the billing and insurance section of our website or call customer service at 717-851-5005 or 877-631-4262.

This disclosure does not apply to Medicare and Medicaid coverages.