Understanding your rights when navigating healthcare costs can make a significant difference. One such right is your entitlement to a Good Faith Estimate (GFE). At ShareWELL, we believe that transparency and education empower our members to make the best decisions for their care.

What is a Good Faith Estimate?

A Good Faith Estimate (GFE) is documentation that healthcare providers and facilities must provide if you’re uninsured or self-pay, detailing the expected costs for medical items and services. This estimate gives you a clearer picture of what you might pay, helping you make informed decisions about your healthcare.

Key Points of a Good Faith Estimate:

• Transparency – Provides a breakdown of expected costs before you receive the service.
• Preventing Surprises – Helps avoid unexpected medical bills by giving you an upfront idea of potential charges.
• Comparison Shopping – Enables you to compare costs between providers and choose the one that best fits your budget.

Your Right to a Good Faith Estimate

The No Surprises Act, effective January 1, 2022, guarantees your right to receive a Good Faith Estimate (GFE) before care is provided. In practice, some providers deliver this information quickly and clearly, while others may require additional follow-up. The most valuable type of GFE is one that includes a detailed, itemized breakdown of services and anticipated charges. Whenever possible, request that both you and your provider sign the estimate—this creates a mutual understanding of costs and adds a layer of protection against unexpected or inflated billing later on.

How to Request a Good Faith Estimate

To request a GFE, you can:

• Contact your healthcare provider directly,

• Request it when scheduling an appointment, or

• Use online patient portals if available.

• Present to your provider as uninsured or self-pay

When requesting, specify all services you expect to need, since the estimate should cover related costs such as surgeon’s fees, facility fees, and ancillary services.

A Note on Maternity Sharing Requests

For maternity Sharing Requests, ShareWELL has clear guidelines to help members and providers navigate costs. Please review our Maternity Brochure for details on eligibility, allowances, and submission requirements.

At your first visit with your OBGYN, we recommend requesting a global maternity package and asking if it can be itemized. An itemized package provides greater clarity on costs for prenatal visits, delivery, and postpartum care, making it easier for ShareWELL to apply your maternity allowances accurately. Not all providers will supply an itemized package, but requesting one early helps avoid surprises and gives you the best chance of maximizing your benefits.

When a provider offers a global maternity package that is not itemized (and includes prenatal care, delivery, and postpartum visits), ShareWELL applies a standard deduction so allowances stretch further:

• $2,000 deduction for a vaginal delivery

• $3,000 deduction for a C-section delivery

This process helps ensure members’ pre- and postnatal allowances remain available for additional maternity needs outside of the bundled package.

Support and Guidance

Our ShareWELL Member Support Team is here to guide you through requesting a GFE, submitting a Sharing Request, and understanding your benefits. We’re committed to making the process as transparent and stress-free as possible.

For additional resources, explore:

👉 Navigating Your Next Planned Procedure
👉 Navigating ER Visits

Final Thoughts

Understanding your right to a Good Faith Estimate is key to managing healthcare costs effectively. And for those preparing for maternity, knowing how global packages are handled ensures your Sharing Request is processed smoothly and fairly.

At ShareWELL, our goal is to support you with the tools, resources, and advocacy you need to confidently navigate your healthcare journey.

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For many, submitting a medical bill and paying a provider directly as a self-pay patient is entirely new. It can feel overwhelming, especially if you’ve never navigated healthcare without traditional coverage. At ShareWELL, we understand these concerns and want to assure you that our advocacy team is here to help every step of the way. In this post, we’ll walk you through what happens after you submit a medical bill so you know exactly what to expect and how we support you.

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