Surprise bills and ambulance bills in Indiana

For non-emergency care, an out-of-network practitioner who treats you at an in-network facility may not be paid more than your plan's network rate unless, at least 5 business days before the service, you got a separate written notice with a good faith estimate and signed it to agree to the higher charge.

Checked against official sources: October 30, 2026.

What Indiana adds

State law

Indiana out-of-network practitioner rules and ground ambulance payment law

Law: IC 27-1-45; IC 27-1-2.3; IC 27-1-45-8, 27-1-45-10

Which plans it covers

Health insurance policies and HMO contracts regulated by Indiana. The ground ambulance rules do not cover the state employee health plan, Medicaid, or ambulance services owned or operated by a health system that bill under the health system. Self-funded employer plans are covered only by federal law.

What it adds

For non-emergency care, an out-of-network practitioner who treats you at an in-network facility may not be paid more than your plan's network rate unless, at least 5 business days before the service, you got a separate written notice with a good faith estimate and signed it to agree to the higher charge. If not, the bill must say in conspicuous type that you are not responsible for more than the plan's rate plus your copay, deductible or coinsurance. If the charge is more than the estimate by more than $100 or 5%, whichever is greater, the provider must explain why in writing. These state rules do not apply to providers that are following the federal No Surprises Act rules.

Ground ambulance

The state protects you

If your state-regulated health plan pays an out-of-network ground ambulance the amount Indiana law sets (the lowest of the local government's rate, 400% of the Medicare rate, or the ambulance's billed charge), that payment is payment in full. The ambulance may not bill you for more, and your cost sharing may be no more than for an in-network ambulance. The plan must pay the ambulance directly. No Indiana rule limits ground ambulance bills for people without insurance.

Law: IC 27-1-2.3-0.5, 27-1-2.3-4, 27-1-2.3-8.1, 27-1-2.3-8.2, 27-1-2.3-8.3

Law: IC 27-1-45-8, 27-1-45-10; IC 27-1-2.3

Itemized bills and price estimates in Indiana

Indiana law gives you a right to a price estimate before scheduled care (see below). Itemized bill rights come from federal law.

Price estimates

If a nonemergency service has been ordered, scheduled or referred for you, you can ask the practitioner and the facility for a good faith estimate of the total price. They must give it within 2 business days after getting the information they need, for free, in writing, by email or online as you prefer. A facility's estimate must include the facility charges and the separate charges of doctors and others who may treat you there, including imaging, lab and other expected services. Estimates are not binding and are valid for 30 days. If you have insurance and the provider is in network, the estimate must use the negotiated price. These rules do not apply to Medicaid members.

Law: IC 25-1-9.8-11 to 25-1-9.8-14; IC 27-1-46-11 to 27-1-46-13

Where to complain in Indiana

Free tools, letters and checklist

Questions about medical bills in Indiana

Am I protected from ground ambulance bills in Indiana?

If your state-regulated health plan pays an out-of-network ground ambulance the amount Indiana law sets (the lowest of the local government's rate, 400% of the Medicare rate, or the ambulance's billed charge), that payment is payment in full. The ambulance may not bill you for more, and your cost sharing may be no more than for an in-network ambulance.

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