Surprise bills and ambulance bills in Maryland

If you are in an HMO, an out-of-network provider is paid by the HMO at rates set by state law. If you have a state-regulated insurance policy and an out-of-network on-call or hospital-based doctor takes an assignment of your benefits, the doctor may bill you only your deductible, copay or coinsurance (and charges for services that are not covered).

Checked against official sources: October 30, 2026.

What Maryland adds

State law

Maryland balance-billing protections (HMO, on-call and hospital-based physician and ambulance assignment-of-benefits laws)

Which plans it covers

Health insurance, nonprofit health service plans and HMOs regulated by the Maryland Insurance Administration. Self-funded employer plans are generally not covered by state insurance law.

What it adds

If you are in an HMO, an out-of-network provider is paid by the HMO at rates set by state law. If you have a state-regulated insurance policy and an out-of-network on-call or hospital-based doctor takes an assignment of your benefits, the doctor may bill you only your deductible, copay or coinsurance (and charges for services that are not covered). Other out-of-network doctors who ask you to assign benefits must first tell you in writing that they are out of network and may balance bill you, with a cost estimate.

Ground ambulance

The state protects you

If you have a state-regulated plan, your insurer must pay a public, volunteer or county-contracted ambulance service directly (for insurers other than HMOs, when the ambulance gets an assignment of benefits). The ambulance service then may not bill you for covered services beyond your copay, deductible or coinsurance, and may not sue you for money the plan owes. The plan must pay an out-of-network ambulance service at least what it pays in-network ambulance services in the same area.

Law: Md. Code, Insurance 15-138

Law: Md. Code, Insurance 14-205.2, 14-205.3, 15-138; Health-General 19-710.1

Itemized bills and price estimates in Maryland

Maryland hospitals must give you an information sheet explaining your bill and your rights, with staff who can help you understand the bill. Before suing, a hospital must attach the original or a certified copy of the hospital bill and the most recent bill to its complaint.

Law: Md. Code, Health-General 19-214.1(f), (g), 19-214.2(i)

Price estimates

On request before or during treatment, a hospital must give you a written estimate of the total charges for non-emergency hospital services, procedures and supplies expected to be billed. The hospital's patient bill of rights must say you can ask for an estimate of hospital charges before care. Hospitals must tell outpatients that they may charge a separate facility fee.

Law: Md. Code, Health-General 19-214.1(f)(1)(vi), 19-342(d)(9); COMAR 10.37.13.03, 10.37.13.08

Where to complain in Maryland

Free tools, letters and checklist

Questions about medical bills in Maryland

Am I protected from ground ambulance bills in Maryland?

If you have a state-regulated plan, your insurer must pay a public, volunteer or county-contracted ambulance service directly (for insurers other than HMOs, when the ambulance gets an assignment of benefits). The ambulance service then may not bill you for covered services beyond your copay, deductible or coinsurance, and may not sue you for money the plan owes.

Nearby states