Below is a quick reference of in-network coverage for major hosptial systems.
For emergency care, you pay the same level as In-network. Must be an emergency as defined in your plan, otherwise Not covered. The “No Surprise Act” addresses out of network care and is summarized below.
✓ Indicates in network facilities.
✘ Indicates out of network facilities, emergency use only
2024 | Aetna | Ambetter* | Anthem* | CareSource | Cigna | Kaiser | Oscar | United Healthcare |
CHOA | ✘ | ✘ | ✘ | ✘ | ✓ | ✘ | ✘ | ✘ |
Emory | ✓ | ✓ | ✓ | ✘ | ✘ | ✓ | ✓ | ✘ |
Grady | ✓ | ✘ | ✓ | ✘ | ✘ | ✘ | ✘ | ✘ |
Piedmont | ✓ | ✓ | ✘ | ✓ | ✓ | ✓ | ✘ | ✓ |
NorthSide | ✘ | ✓ | ✓ | ✓ | ✘ | ✓ | ✓ | ✓ |
Wellstar | ✓ | ✓ | ✘ | ✓ | ✓ | ✘ | ✓ | ✘ |
2023 | Aetna | Ambetter* | Anthem* | CareSource | Cigna | Kaiser | Oscar | United Healthcare |
CHOA | ✓ | ✘ | ✘ | ✓ | ✓ | ✓ | ✘ | ✓ |
Emory | ✓ | ✓ | ✓ | ✘ | ✘ | ✓ | ✓ | ✘ |
Grady | ✓ | ✓ | ✘ | ✓ | ✘ | ✘ | ✓ | ✘ |
Piedmont | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✘ | ✓ |
NorthSide | ✘ | ✓ | ✓ | ✘ | ✘ | ✓ | ✓** | ✓ |
Wellstar | ✘ | ✓ | ✘ | ✓ | ✓ | ✘ | ✓ | ✘ |
2024 | Aetna | Ambetter | Anthem | AMGP | CareSource | Cigna | United Healthcare |
Candler | ✘ | ✓ | ✓ | ✘ | ✓ | ✓ | ✓ |
Memorial University | ✓ | ✓ | ✓ | ✘ | ✘ | ✘ | ✘ |
St. Joseph’s | ✘ | ✓ | ✓ | ✘ | ✓ | ✓ | ✘ |
Effingham Health System | ✓ | ✓ | ✓ | ✓ | ✓ | ✘ | ✓ |
2023 | Aetna | Ambetter | Anthem | CareSource | Cigna | United Healthcare |
Candler | ✘ | ✓ | ✓ | ✓ | ✓ | ✓ |
Memorial University | ✓ | ✓ | ✓ | ✘ | ✘ | ✘ |
St. Joseph’s | ✘ | ✓ | ✓ | ✓ | ✓ | ✘ |
2024 | Ambetter* | Blue Cross SC*** | Molina | United |
Beaufort Memorial | ✓ | ✓ | ✘ | ✘ |
Coastal Carolina | ✓ | ✓ | ✓ | ✓ |
Hilton Head | ✓ | ✓ | ✓ | ✓ |
Memorial University** | ✓ | ✘ | ✘ | ✘ |
Candler** | ✓ | ✘ | ✘ | ✘ |
2023 | Ambetter* | Blue Cross SC | Molina |
Beaufort Memorial | ✓ | ✓ | ✘ |
Coastal Carolina | ✓ | ✓ | ✓ |
Hilton Head | ✓ | ✓ | ✓ |
Memorial University** | ✓ | ✘ | ✘ |
The “No Surprises Act” is a significant piece of healthcare legislation enacted in the United States to protect consumers from unexpected and often exorbitant medical bills. Officially titled the “No Surprises Act of 2020,” it was included as part of the Consolidated Appropriations Act, 2021, and became effective on January 1, 2022.
This act primarily addresses the issue of surprise medical billing, a situation that arises when patients inadvertently receive care from out-of-network healthcare providers, often during emergencies or at in-network facilities. As a result, patients are unexpectedly billed for the difference between what their insurance covers and the out-of-network provider’s charges, which can lead to significant financial burdens and distress.
Key provisions of the No Surprises Act include:
In summary, the No Surprises Act is a crucial piece of legislation aimed at preventing surprise medical bills and protecting consumers from unexpected and unaffordable healthcare costs. It aims to create a fairer and more transparent healthcare system by establishing rules and mechanisms to resolve billing disputes and ensure patients are not financially burdened by out-of-network care.