What Is a Good Faith Estimate?

Plain-English guide · Reviewed for 2026

If you don't have insurance — or you choose not to use it — you have a right most people don't know about: a Good Faith Estimate of what your care will cost, before you get it. It's one of the strongest consumer protections in medical billing, and it can save you from a shocking surprise bill.

The basics

Under the federal No Surprises Act (in effect since 2022), patients who are uninsured or self-pay are entitled to a written Good Faith Estimate of expected charges for scheduled services. It should list the services, the provider, and the expected cost — given to you in advance.

Why it matters

The Good Faith Estimate does two things: it lets you plan and compare prices before committing, and it gives you leverage if the final bill is much higher.

The $400 rule: If your final bill is at least $400 more than your Good Faith Estimate, you may be able to dispute it through the federal patient-provider dispute resolution process. Keep your estimate — it's your evidence.

How to use it

  1. Ask for it. If you're uninsured or paying cash for a scheduled service, request a Good Faith Estimate in writing before your appointment.
  2. Keep a copy. Save it somewhere you'll find it when the bill arrives.
  3. Compare when billed. Line up the final bill against the estimate.
  4. Dispute a big gap. If the bill is $400+ over the estimate, start the dispute process — and ask the provider to explain the difference first.

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