Since January 2022, federal law has required health providers to give a written estimate of what care will cost to patients who are uninsured or who are choosing not to use their insurance. It is called a good-faith estimate, and most people who are entitled to one have never heard of it.
Who it applies to
You qualify if you have no health coverage, or if you have coverage but are not using it for this care — self-pay patients count. It applies to scheduled care, not to an emergency you arrive at unconscious.
What you should get
The estimate must be in writing, in plain language, and it must cover the expected charges for the primary item or service and the things that reasonably go with it — the facility, the surgeon, the anaesthesia, the supplies. A quote for the operation that quietly omits the anaesthetist is not a good-faith estimate.
Timing is set by rule rather than goodwill. If you schedule care several days out, the provider has a short window to give you the estimate; if you simply ask for one without scheduling anything, they must still provide it. If you are shopping between hospitals, ask each of them — this is exactly the situation the rule was written for.
If the bill arrives much higher
This is the part with teeth. If your final bill from a provider substantially exceeds their good-faith estimate, you can start a patient–provider dispute resolution process, in which an independent third party reviews whether the extra charges were justified. The threshold is a fixed dollar amount above the estimate, and there is a deadline from the date of the bill, so keep the estimate and act on it rather than filing it away.
Two practical notes. Keep every version of the estimate you were given — the dispute process compares the bill to what you were told. And raise it before paying: it is far harder to unwind a payment than to challenge a bill.
If you are insured
The good-faith estimate rule is aimed at self-pay patients, but you are not without options. Ask your insurer for the negotiated rate for the specific procedure code at the specific hospital, and ask the hospital to confirm every provider who will be involved is in network. Get both answers in writing.
Where to check the rule
The Centers for Medicare & Medicaid Services publishes the current requirements, thresholds and deadlines, and they are updated from time to time. Check the official page rather than any figure quoted second-hand — including here.