Surprise bills and ambulance bills in Illinois

For emergency care, and for care from an out-of-network provider at an in-network facility, you pay only your in-network cost sharing, and the provider, facility and insurer may not bill you more.

Checked against official sources: October 30, 2026.

What Illinois adds

State law

Illinois Insurance Code Section 356z.3a (billing for emergency services and nonparticipating providers)

Which plans it covers

Individual and group health insurance and HMO plans regulated by the Illinois Department of Insurance. It does not cover self-funded employer plans, short-term plans or air ambulance.

What it adds

For emergency care, and for care from an out-of-network provider at an in-network facility, you pay only your in-network cost sharing, and the provider, facility and insurer may not bill you more. State law also protects you in neonatal intensive care billed as emergency services.

Ground ambulance

The state protects you

Starting January 1, 2027, if you have state-regulated health insurance, plans must cover emergency and urgent ground ambulance services, and you pay no more out of pocket for an out-of-network ground ambulance than for an in-network one. Your cost sharing is the lesser of your plan's emergency room copay or coinsurance or 10% of the recognized amount. Once the ambulance accepts the insurer's payment, it may not bill you beyond your deductible, coinsurance or copay.

Law: 215 ILCS 5/356z.3a(b-10), (b-15)

Law: 215 ILCS 5/356z.3a; 215 ILCS 125/5-3

Itemized bills and price estimates in Illinois

Illinois law gives you a right to an itemized bill.

Every hospital bill must show the dates of service, a short description of services, the amount owed, a billing contact, and notice that you can get an itemized bill on request. If a hospital bills you, it must give you an itemized statement of charges when you ask. Hospitals must have a phone number for billing questions and disputes on every bill and collection notice, return calls within 2 business days and answer letters within 10 business days.

Law: 210 ILCS 88/20, 88/25

Price estimates

If a hospital charges a separate facility fee for outpatient services, it must have a policy to tell you as soon as reasonably practicable that you may be charged a facility fee, what it covers and whom to contact for more information.

Law: 210 ILCS 88/12

Where to complain in Illinois

Hospital bills and financial assistance: Illinois Attorney General, Health Care Bureau · 1-877-305-5145
A hospital did not give you a required discount, did not screen you, billed you wrongly or sent your bill to collections without following the Fair Patient Billing Act.
Health insurance: Illinois Department of Insurance, Office of Consumer Health Insurance · 1-877-527-9431
Problems with a state-regulated health insurance plan or HMO, including surprise bills and denials.
Debt collectors: Illinois Department of Financial and Professional Regulation (IDFPR)
A licensed collection agency broke state collection rules.
Attorney general: Illinois Attorney General, Consumer Protection Division · 1-800-386-5438
Other consumer complaints, including credit reporting of medical debt.

Free tools, letters and checklist

Questions about medical bills in Illinois

Am I protected from ground ambulance bills in Illinois?

Nearby states

National rules that apply in every state

Nonprofit hospitals (federal rules)

Each nonprofit hospital must have a written financial assistance policy (FAP).

Law: 26 U.S.C. 501(r)(4); 26 CFR 1.501(r)-4

Before any ECA, the hospital must tell you about financial assistance and wait at least 120 days from the first bill sent after you left the hospital.

Law: 26 CFR 1.501(r)-6(c)(3)

You can apply for at least 240 days from the first bill sent after you left the hospital.

Law: 26 CFR 1.501(r)-1(b)(3)

If you apply during the application period, even with an incomplete application, the hospital and its collectors must stop starting or continuing ECAs until the hospital decides, or until you fail to send requested information within a reasonable time.

Law: 26 CFR 1.501(r)-6(c)(8)

Once you are found eligible, the hospital cannot charge you more than the amounts generally billed (AGB) to people with insurance for emergency or other medically necessary care, and must charge less than its full gross charges for other covered care.

Law: 26 U.S.C. 501(r)(5); 26 CFR 1.501(r)-5

Surprise bills (No Surprises Act)

With most private health plans (job-based plans, Marketplace and other individual plans), you are protected from surprise out-of-network bills for emergency care, for non-emergency care at an in-network hospital, hospital outpatient department or ambulatory surgical center, and for air ambulance services.

Law: 42 U.S.C. 300gg-111, 300gg-131, 300gg-132, 300gg-135

For protected services, you can't be charged more than your in-network cost-sharing (copay, coinsurance, deductible).

Law: 42 U.S.C. 300gg-131, 300gg-132

Ground ambulance services are generally not covered by these federal protections, unless a state law has different rules.

Law: CMS, Know your rights when using insurance

If you don't have insurance or won't use it, providers and facilities must usually give you a written good faith estimate.

Law: 42 U.S.C. 300gg-136; 45 CFR 149.610

If one provider's or facility's bill is at least $400 more than its good faith estimate, you can use the federal patient-provider dispute resolution process.

Law: 45 CFR 149.620(a)(2)(ii), (c)(1)

Credit reports

A collection account generally cannot be reported for more than 7 years.

Law: 15 U.S.C. 1681c(a)(4), (c)(1)

For a veteran's medical debt (care authorized by the VA from a non-VA provider, or a bill the VA charged in error), nationwide credit bureaus may not report it until 1 year after the care, and may not report it once it is fully paid or settled, when they know it is a veteran's medical debt.

Law: 15 U.S.C. 1681c(a)(7), (8); 15 U.S.C. 1681a

If a medical debt on your credit report is wrong, you can dispute it with the credit bureau for free.

Law: 15 U.S.C. 1681i(a)(1)

Debt collectors

A debt collector must give you validation information about the debt, including the amount and how to dispute it.

Law: 12 CFR 1006.34

If you dispute the debt in writing within the validation period, the collector must stop collecting the disputed amount until it sends you verification of the debt.

Law: 12 CFR 1006.38(c), (d)(2)

A debt collector must not sue or threaten to sue you on a time-barred debt, meaning a debt whose statute of limitations has run out.

Law: 12 CFR 1006.26(b)

Itemized bills and price lists

Your medical and billing records kept by a health care provider are part of your 'designated record set'.

Law: 45 CFR 164.501 (designated record set); 45 CFR 164.524(b)(2)

If Medicare paid for an item or service, you can ask the provider in writing for an itemized statement.

Law: 42 U.S.C. 1395b-7(b)

Every hospital must post online a machine-readable file of all its standard charges, and a consumer-friendly list of at least 300 shoppable services (or an online price estimator tool).

Law: 45 CFR 180.40, 180.50, 180.60

Medicaid and Medicare

If you qualify for Medicaid, it can pay for covered care you got up to 3 months before the month you applied, if you were eligible then.

Law: 42 U.S.C. 1396a(a)(34), 1396d(a); Pub. L. 119-21, sec. 71112 (July 4, 2025)

If you are in the Qualified Medicare Beneficiary (QMB) program, Medicare providers may not bill you for Medicare deductibles, coinsurance or copays for Medicare-covered care.

Law: 42 U.S.C. 1396a(n)(3)(B); CMS

If your health plan denies a claim

You must file an internal appeal within 180 days (6 months) of the notice that your claim was denied.

Law: 45 CFR 147.136(b); HealthCare.gov

After a final denial, you can ask for an external review by an independent reviewer within 4 months.

Law: 45 CFR 147.136(c), (d); HealthCare.gov

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