Skip Ribbon Commands
Skip to main content
No-Surprise-Act-Cost-Calculator-2
  • Inicio

    • Estimated cost of services received in Puerto Rico through an out-of-network provider

    In compliance with Chapter 48 of the Puerto Rico Health Insurance Code, also known as the "Patient Protection from Surprise Medical Bills Act" (Law 134-2020), this law provides consumer protection, transparency, cost control, and accountability for services received in Puerto Rico through providers outside the provider network.

    In compliance with the Law for the Protection of Patients from Surprise Medical Bills(Law 134-2020), accidental, involuntary, out-of-network charges are not subject to payment or billing beyond the financial responsibility incurred under the in-network service contract.

    This section provides the estimated cost for the most frequently used out-of-network item(s) or services.

    Refer to the table provided below, use the calculator, and follow the steps to determine the approximate cost of the service:

    1. Select the "Service Type" from the list (drop-down).
    2. Select the "Service" from the list (drop-down).
    3. Enter the rate that the out-of-network provider will charge.
    4. Select the "Cost Sharing" form for the calculation.  
    5. The estimated cost of services received in Puerto Rico through an out-of-network provider is displayed in the calculator according to the recorded data.
    Reset

    Anticipated estimated cost calculation

    In-network provider rate ?

    Min($) Max($) Median
    $ 0.00 $ 0.00 $ 0.00

    Copayment ?

    Min($) Max($) Median
    $ 0.00 $ 0.00 $ 0.00

    Coinsurance ?

    Min(%) Max(%) Median
    0.00 % 0.00 % 0.00 %

    Estimated cost for using a network provider. ?

    $ 0.00

    Estimated reimbursement for using an out-of-network provider ?

    $ 0.00

    Anticipated estimated cost for receiving a service in Puerto Rico through a non-participating network provider. ?

    $ 0.00