How do I get a good faith estimate, and what if my bill is much higher?

Who can get a good faith estimate?

People who are uninsured, and people who have insurance but choose not to use it for the care (self-pay), usually have the right to a good faith estimate of expected charges Source 11. You get one when you ask for it, or when you schedule care far enough ahead. The minimum notice is 3 business days (CMS, published October 5, 2026).

If you have insurance and plan to use it, the rules are different: see "I have insurance" below. To pay for care yourself, tell the provider when you book that you are self-pay, and ask for the estimate in writing.

When should I get it, and what must it include?

Ask when you book the care, or earlier, while you compare prices. How fast the estimate must arrive depends on when you ask Source 22:

• When you book care far enough ahead, the estimate is due within 1 business day (45 CFR 149.610 (eCFR), published 2026) after you book. If you book further in advance, the provider may take up to 3 business days (45 CFR 149.610 (eCFR), published 2026).
• When you ask for an estimate without booking, it is due within 3 business days (45 CFR 149.610 (eCFR), published 2026) after you ask.

The estimate must list Source 22:

• the items and services you are expected to get, with their billing codes and expected charges;
• the providers expected to give the care;
• that you may dispute a bill that is substantially higher than the estimate;
• that the estimate is not a contract.

Keep it with your papers. You need it if you dispute the bill later. Ask for a separate estimate for anything not listed, such as anesthesia or lab work, if you expect it.

I have insurance. What do I get instead?

For now, nothing new under this rule. The rule also calls for providers to send an estimate to your health plan, so the plan could send you an "advanced explanation of benefits" before care. Federal agencies have held off on enforcing that part until they write the rules for it, and they had not finished those rules when we last checked Source 33.

What you can do meanwhile:

• Ask your plan what it will pay for the service and what your share will be, and whether you need approval first (prior authorization).
• Check that every provider is in network, including the facility, the surgeon, anesthesia and the lab.
• Know your protections against surprise bills. Our guide to the No Surprises Act explains them.
• Ask for a good faith estimate as a self-pay patient if you decide not to use your insurance for the care Source 11.

My bill is much higher than the estimate. Can I dispute it?

Yes, if you were uninsured or self-pay and got a good faith estimate. You can start a federal dispute (patient-provider dispute resolution) when the bill is at least $400 (CMS, published October 2, 2026) more than the estimate Source 44.

1. Check the deadline. You must start within 120 days (CMS, published October 2, 2026) of the date on the first bill Source 44.
2. Gather your papers: the good faith estimate and the bill. An itemized bill helps you compare them line by line. Our itemized bill request letter has the words to ask for one.
3. Start the dispute with the federal government on the CMS page for disputing a bill.
4. Know the fee. The dispute costs $25 (CMS, published October 2, 2026), and if the reviewer decides in your favor, the fee comes off what you owe Source 44.

This dispute is only for uninsured and self-pay patients with a good faith estimate. If you have insurance, use your plan's appeal process, as our guide on appealing an insurance denial explains, or complain about a surprise bill (see below).

What happens to my bill during the dispute?

The provider has to wait. While the dispute is open, the provider may not send the bill to collections, add late fees or punish you for disputing, and any collection it already started must stop Source 44.

You and the provider can still settle while the dispute is open. If you settle, the bill must drop by at least $12.50 (CMS, published October 2, 2026). Get any agreement in writing before you pay.

Who can help me file?

• The federal No Surprises help line answers questions about estimates and disputes: 1-800-985-3059. It is open every day and gives help in many languages Source 11.
• The No Surprises Help Desk takes questions and complaints online, with your documents, and may refer them to a federal or state agency Source 55.
• The provider's billing office can correct a mistake before you file. Ask it to compare the bill with the estimate, and our guide on how to negotiate a medical bill covers what to say.