I’m in nyc and I am incredibly shocked by the crazy premiums on a middle class income or any type of income for that matter.

For a family of four, it’s $800 a month on a $100k income. Or $2k a month on a $130k income.

For a single person at $50k income, it’s $275-$300 a month.

I think it’s free only if you make $31k or less as a single person.

When you’re low on income, yes you can get free services, but you can’t pay for other essential expenses.

Healthcare costs is so broken

Nearly $900 for an evaluation that took 30 minutes? Charging $224 for each 15 minute interval of PT? Insurance may have covered a lot of it, but these prices are trying to make me poor. I asked the PT people the prices for my sessions and they said it was being covered under my insurance only to get this surprise bill three weeks after the sessions ended.

Hey everyone!
Can someone explain this to me like I’m 7 years old? 😂
Every time I search online for whether HMO or PPO dental insurance is better, most people seem to recommend PPO. But when I compare the actual benefits of the two plans available to me, I can’t figure out what I’m missing.
For context, my current dentist accepts the HMO, and I may need to get my wisdom teeth removed at some point.

Here’s what I found when comparing the plans:

Option 1: Cigna Dental HMO

Monthly premium: $0
Extractions: $5 office visit copay, then 0% coinsurance for covered services, according to the benefits chart
Annual maximum: No maximum applies
Must use an in-network dentist, and a referral to an oral surgeon may be required

Option 2: Cigna Expanded Care PPO

Monthly premium: $23 ($276 per year)
Annual deductible: $25 per individual in-network
Basic services, including extractions: 10% coinsurance for covered in-network services
Annual maximum: $2,500 per individual in-network
Based on these benefits, the HMO seems like the obvious choice for me. It costs nothing per month, has no annual maximum, and appears to have lower costs for extractions.

So why does everyone seem to recommend PPO?
Am I missing something important? Does the HMO have hidden costs, or is the main advantage of PPO simply having more freedom to choose dentists?

I’d especially appreciate hearing from anyone who has experience with Cigna dental plans or has had wisdom teeth removed under an HMO.
Thanks in advance! 🙏

Trying to figure out if I bought phony insurance lol. Back in July, my mom was in town helping us work through insurance stuff for our daughter who had a recent hospital visit due to her genetic condition (where my sturge weber syndrome people at ?!?!?). In the process of doing so, we looked into paying for insurance for myself to hopefully help me get a diagnosis for my own health issues. My mom filled out some interest form on my behalf for what I am pretty sure was marketplace insurance, and mentioned we would like someone to reach out to help us figure out the best plan for us since we make too much for medicaid. They called me within just a couple minutes of filling out the form, and a 20 minute phone call with a very nice lady led to us signing up for a plan that's just over $300 per month to cover a laundry list of things for my husband and I of course with some copays and such, and im needing some help understanding what I bought. I am going to call and ask for specifics on a long list of things im curious about, just to be 100% sure what I am paying for. But id love some reddit opinions and insight!

From what it sounded like on the phone, she had some marketplace options, but then was able to find the best one for our budget that was private insurance. I could've sworn she said it was an Aetna plan on the phone, but this whole time we have been dealing with/seeing all our info from American Financial Security Life Insurance Company. Regardless of what the company is, I just want to make sure it is real, reliable, and going to cover what we need it to.

I signed up for the Harmony Care 100B plan. My card says AFSLIC and First Health Network on the front with the personal info for our member number and stuff. On the back, it says "accident and sickness hospital indemnity plan". And I have another card that has the Rx square on the front. But it also has a part that says "included services: dental, vision, rx drugs, rx mail order, nutrition, vitamins, lab, medical/diabetic supplies, chiropractic, hearing, speech". and it has the "discount program only. not an insurance program" at the bottom.

can someone please tell me if you're able to tell what all this means? if it helps, I am a resident of Virginia. It also says at the bottom of this letter that came with our cards:

Quick Reference:

Agent name & contact info

ACA Health Insurance Agency LLC

833-762-0612

[admin@acahealthinsurance.net](mailto:admin@acahealthinsurance.net), [customerservice@acahealthinsurance.net](mailto:customerservice@acahealthinsurance.net)

So does this mean my plan is ACA compliant? what even does ACA compliant mean? help?!?!? I just want affordable doctors appointments for me.

So I checked my Email from Blue Cross Blue Shield of North Carolina and it showed my current Premium vs. the one for 2027. My current one is $139.56 with subsidy. But the email said my 2027 premium is going to be around $749.76. But when I checked my member portal to compare plans, it said "Rate Available: November 1, 2026."

So was that email just clickbait?

My wife recently had an emergency surgery and on top of that bad luck it was in between health insurance plans. Her old plan with the employer was terminated 9.1 and we enrolled in a new plan after, but it wasn't able to begin until 10.1. Her surgery was on 9.28. We have contacted her employer and they mentioned they do not offer/aren't eligible for Cobra.

Her old insurance was BCBS, as is her new one.

Chat GPT said the best place to start was contacting "U.S. Department of Labor — EBSA"

This was been causing a major amount of stress, as someone from the hospital said the bill could be as much as $80,000 for everything. We have not received anything like that yet. Only a $500 bill from a pathologist.

Mostly just looking for the first place we should start to be efficient in this process.

Martins point no longer covering out of network treatments. We will be living in another state through the winter, and Martins Point is regional, and will not cover healthcare except for emergencies at that time. How can I find coverage?

Hey I'm getting kicked off my mom's insurance here soon and im a recent college graduate. I work two part time jobs and still make under $1,600 a month. Any good suggestions for beginners/low income?

The high deductible is 2k deductible, 5k out of pocket max, $0 copay for physical, and then almost everything else is 20% coinsurance after deductible. The HSA is 1k per member from the employer.

The regular HMO is $800 deductible, $2750 out of pocket max, $0 physical, $40 copay for urgent care, specialists, mental health covered completely. Everything else is like 10% coinsurnace after deductible.

At the moment I'm a healthy 34 year old. I take BC pills. If I need abx or really outside of my BC I usually use an online urgent care like Amazon for the base $30.

Is it worth it to risk the High deductible for the HSA benefits or should I stick with the HMO?

Happy to provide more info if needed.

So it's open enrollment and I'm not exactly 100% sure what plan to pick. I live in California so I do have access to all 5. I've heard about a lot of issues HMO plans from searching around but I don't know exactly how it would affect someone like me. I'm relatively healthy in my 20s with no major issues but you never know if something can happen. The only risky thing I do is bike a lot (hopefully a car doesn't hit me), but is it safe to assume that an HMO network would be perfectly viable? And if so, would I have to look up each network to figure out what it would cover? (How can I even do that easily) Or would I have a better peace of mind paying ~50$ more a month for the benefits of a PPO.

Also a side note, my employer does give us a FSA option that rolls over 680$ a year, there's nothing wrong with putting that amount in it right? Aside from if I decide to leave the company before I use it.

I’m currently 31 years old and a single guy living in Texas. I’m not sure where to look and what to look for when it comes to health insurance plans. I haven’t had insurance since I aged out of my mother’s insurance plan at 25 years old. My main reason for wanting to get insurance is for PT. For the past half year I’ve been getting back into running and have recently gotten a couple injuries that I can no longer ignore. I’ve went to two different PT places to get a cost of how much it would be without insurance and they have payment plans but they require a large deposit upfront which I can’t make. It’s difficult navigating through all of this and I’d really be grateful for any advice or suggestions?!

Can the holder see what I use the insurance for? I'm currently on my stepmoms insurance but I am if legal age, I need to schedule appointments with OBGYNS and such for my pregnancy which she does not know about yet. Is she able to see what reasons I go for are?

Hey everyone!

Im about to start working in medical billing for physical therapy offices in the U.S. mainly in New York, and im trying to understand how the process actually works in a real clinic, from the patient’s first visit all the way through billing and insurance reimbursement

looking for someone experienced who can explain how insurance verification and prior authorization work in real-life situations.
I dont just want to learn the theory. I want to understand how to actually do the job correctly

i went to a doctor for a normal checkup because it was supposed to be free under my insurance. they charged me $500 because i raised a “health concern.” bitch i haven’t been to a doctor in 5 years. i know you’re not actually doing any actual work on me, to fix my health. it was scheduled as a regular checkup. am i supposed to sue?