Wisconsin
How you’re protected (and not) from surprise emergency medical bills in Wisconsin
MADISON, Wis. (WMTV) – Since 2022, American consumers have had billing protections when getting emergency care.
The No Surprises Act (NSA) protects you from surprise bills for covered emergency out-of-network services, including air ambulance services, and surprise bills for covered non-emergency services at an in-network facility, the Wisconsin Office of the Commissioner of Insurance explains online.
The office, which is the primary enforcer of NSA in Wisconsin, also investigates any complaints.
According to Sarah Smith, OCI director of public affairs, the office has seen different ways insurance providers have handled ground ambulances, which are exceptions.
Ground ambulances, compared to air ambulances (e.g. helicopters), are excluded from the federal protections that come with the No Surprises Act.
| No Surprises Act protects you from unexpected out-of-network bills from: | No Surprises Act does NOT protect you from: |
|---|---|
| Emergency room visits | Ground ambulance services |
| Non-emergency care related to a visit to an in-network: – Hospital – Hospital outpatient department – Ambulatory surgical center |
Vision-only and dental-only insurance |
| Air ambulance services | Short-term limited duration and health care sharing ministry plans |
Smith nevertheless encourages Wisconsinites to reach out to the state office with any concerns about hospital bills. She said, “We’re happy to look through it and make sure that it was within compliance of all laws that we have the authority under.”
The OCI also encourages people to talk with their insurance providers before any incidents. “Just know in advance what’s covered, what’s not,” Smith said.
Find the No Surprises Act complaint form here.
Learn more about the NSA here.
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