All tools · Surprise Bill Shield

Florida's Balance Billing Law for Emergency Care

Use the free tool — Surprise Bill Shield

You got a bill from a doctor you never chose

You went to an in-network hospital, or you had an emergency, and now a bill arrived from a doctor, anesthesiologist, radiologist, assistant surgeon, lab, or air ambulance you never picked. Since 2022, federal law bans many of these bills. Florida law bans more of them. This page explains what to check. It is not legal advice.

What federal law bans

The No Surprises Act, effective January 1, 2022, bans balance bills for:

• Emergency services, including air ambulance
• Out-of-network providers at an in-network facility, unless you signed a written notice-and-consent at least 72 hours ahead

Consent is not allowed for emergency care, anesthesiology, radiology, pathology, neonatology, assistant surgeons, hospitalists, intensivists, or diagnostic services, so a signature for those doesn't count. This applies to employer plans, marketplace plans, and individual plans. It does not apply to ground ambulances. Source: CMS, No Surprises Act, your rights.

What Florida law adds

Florida's Fla. Stat. 627.64194 also bans balance billing for emergency services and for covered non-emergency services at an in-network facility when you had no ability to choose the provider.

What you should actually owe

If the law applies, you should owe only your in-network cost sharing — the amount that counts toward your in-network deductible, shown on your insurer's Explanation of Benefits (EOB). Not the full billed amount.

• Medicare: a provider who accepts assignment cannot balance bill you. One who doesn't accept assignment is limited to 15% over the Medicare-approved amount. Source: Medicare.gov.
• Uninsured or self-pay: you should have gotten a Good Faith Estimate. You can dispute a bill that is $400 or more above it. Source: CMS.
• Ground ambulance: not covered by the No Surprises Act.

Send these letters — and where to complain

Don't ignore the bill and don't let it go to collections. Respond in writing before the due date, and keep every EOB.

• To the provider: state the facts of the care, cite the statute, say you will pay only the in-network cost sharing shown on your EOB, and ask them to re-bill your insurer and stop collection.
• To the insurer: ask them to reprocess the claim at in-network cost sharing under the No Surprises Act, and to confirm it in writing.
• If it isn't fixed, file a complaint with the federal No Surprises Help Desk: 1-800-985-3059. For Florida-regulated plans, contact the Florida Department of Financial Services: 1-877-693-5236.

What to do next

This page can't look at your specific bill. The free tool can. Paste who billed you, how much, where the care happened, and what your insurance paid, plus your plan type. In a few seconds it reads your own numbers against these laws, tells you whether your bill appears protected, what you should owe instead, and gives you the letters to send. Nothing you paste is stored. This is not legal advice — confirm with the CMS No Surprises Help Desk or Florida DFS before you rely on it.

Surprise Bill Shield explains the No Surprises Act and Florida balance-billing law in plain language; it can be wrong, and it is not legal advice. Confirm with the CMS No Surprises Help Desk, the Florida Department of Financial Services, or an attorney. Nothing you paste is stored.