58 When balance billing isn’t allowed, you also have the following protections: • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in - network). Your health plan will pay out - of - network providers and facilities directly. • Your health plan generally must: o Cover emergency services without requiring you to get approval for services in advance ( prior authorization). o Cover emergency services by out - of - network providers. o Base what you owe the provider or facility ( cost - sharing) on what it would pay an in - network provider or facility and show that amount in your explanation of benefits. o Count any amount you pay for emergency services or out - of - network services toward your deductible and out - of - pocket limit. If you believe you’ve been wrongly billed , you may contact the applicable entity responsible for enforcing the federal and/or state balance or surprise billing protection laws. Visit www.dol.gov for more information about your rights under federal law.