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Who can get help?
If you get a surprise bill for services on or after January 1, 2022:
The law applies to anyone with any type of health insurance except Medicare.
If you get a surprise bill for services between January 1, 2020, and December 31, 2021:
The law applies only to state-regulated insurance plans. You have a state-regulated plan if:
- Your insurance card has “DOI” (for department of insurance) or “TDI” (Texas Department of Insurance) printed on them. See examples
- You have insurance with:
- Employees Retirement System of Texas (ERS): HealthSelect and other ERS plans
- Teacher Retirement System of Texas (TRS): TRS ActiveCare and TRS-Care Standard for Non-Medicare Retirees
- Texas Farm Bureau or an employer plan that has opted into the Texas balance billing laws. The patient's insurance card might have TXI on it.
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What bills are covered?
If you get a surprise bill for services on or after January 1, 2022:
The law bans balance bills:
- In emergencies.
- For air ambulance services.
- For care you receive at an in-network hospital.
- For labs and imaging an in-network doctor ordered.
If you get a surprise bill for services between January 1, 2020, and December 31, 2021:
The law bans balance bills:
- In emergencies.
- For care you receive at an in-network hospital.
- For labs and imaging an in-network doctor ordered.
If you get a balance bill, visit our How to get help with a surprise medical bill webpage.
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Can I still see the doctor of my choice?
The law doesn’t limit your options or change your health plan’s coverage for out-of-network care. If your health plan allows you to pick an out-of-network doctor, you can still do so. The law applies:
- In emergencies.
- When you didn’t pick the doctor (such as the radiologist who reviewed your X-ray).
- When you get air ambulance services.