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What is the Transparency in Coverage (TiC) Rule?

The Transparency in Coverage Rule is a federal regulation designed to empower consumers to shop and compare costs among various providers before receiving care, helping consumers better understand the cost of their health care.


There are two (2) components to this regulation, 1) the machine-readable files and, 2) an Internet-based price comparison tool. 

Machine-readable file (MRF)

Machine-readable file (MRF)

The machine-readable file must conform to a non-proprietary, open-standards format that is platform independent and made available to the public without restrictions.


The machine-readable files consist of an In-Network Rate (rates for all covered items and services between the plan or issuer and in-network providers) and an Allowed Amount (allowed amounts for, and billed charges from, out-of-network providers).


The MRF does not contain any benefit details or member personal health information.


The Departments of Health and Human Services, Labor, and the Treasury envision third-party developers and other entities will download, process, and compile this data, creating more advance price transparency tools. This data is not designed for member or consumer usage. 

Internet-based price comparison tool

Internet-based price comparison tool allowing an individual to receive an estimate of their cost-sharing responsibility for a specific item or service from a specific provider or providers, for 500 covered items and services as of 1/1/23 and all covered items and services as of 1/1/24.

Consolidated Appropriations Act


The Consolidated Appropriations Act (CAA) was established to protect consumers from unexpected costs related to health care billing by offering transparency about health care costs.


The No Surprises Act (NSA) provides protections from surprise medical bills for coverage of emergency services, coverage of non-emergency services performed by out-of-network providers at in-network facilities, prohibits balance billing, establishes special rules for high deductible health plans, and applies external review requirements for surprise billing.


Learn more about the No Surprises Act.

Independent Dispute Resolution (IDR) is an arbitration process to resolve NSA-eligible payment disputes. 

Billing questions

Resources and information are available if you believe you have been wrongly billed.


Get help by phone

You can send complaints about potential violations of federal law or state law to the U.S. Department of Health & Human Services at 1-800-985-3059.


Get help online

You can also visit the Centers for Medicare & Medicaid Services website to learn about federal guidance to end surprise bills and find help from your state agency

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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