Surprise medical bills arise when a consumer covered by a health plan is unexpectedly treated by an out-of-network provider and is required to pay the difference between what the plan pays and the provider's charge. The issue of surprise bills, which can often expose a consumer to thousands of dollars of unforeseen medical costs, is widespread. In 2017, one in six Americans covered by an employer-sponsored plan received a surprise medical bill for out-of- network care despite having health insurance. One in ten elective hospital admissions and one in five admissions from emergency departments result in surprise bills.
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