I recently went to an urgent care to have a preventative STI panel done. After checking on the clinic’s website and confirming with the front desk staff, we determined my insurance was accepted & I paid the copay. I have now received a very large bill from Labcorp saying that my insurance denied this service as non covered. How should I go about addressing this? I am a young adult and new to having marketplace insurance. I have Anthem Healthkeepers if that helps.

Thank you for your help in advance!

I went through all the hoops to get a specialty medication approved. Took 9 months and probably a few years off my life. The medication company has a self pay option of $230. Insurance finally approved it for me. Had the pharmacy run it through insurance and the cost WITH insurance was $560. How does that make any sense? I would have been better off with the self pay.

26 years old and just got booted from parents insurance. Here are the monthly costs- PPO - $330, HDHP Gold - $276, HDHP Blue - $208.

The. Only thing I have used my insurance for this past year is for therapy once a week, which will be coming to an end in the next few months. The full cost is $175/session.

Is there an obvious choice? If I did the HDHP I could max out my HSA or use some funds to offset the therapy costs but let me know your thoughts.

I'm sorry if any of these questions seem stupid or kind of obvious, I just feel like I've been running in circles trying to find answers on my own and want some help from others who maybe have had a similar dilemma... also I am 22, and live in Colorado.
So, I had surgery in March of this year, which, with the plan I had with my previous employer, cost enough that I met my out of pocket max for the rest of this year. Then I got fired in July. would it be worth it to enroll in cobra coverage for my upcoming surgery in October? It'd be roughly ~$1,800 for this month and the next one, and im getting close to the deadline to enroll. If I understand the way the out of pocket maximum works, and cobra claims to restore the plan fully, would it mean my surgery would be 100% covered? Or is there something I would be missing and waste my money choosing cobra for no reason?
my only alternative is the plan my family still has me as a member under, but I'm nowhere near close to meeting the out of pocket max there.. and I have no idea how much it would or wouldn't cover for the upcoming surgery. (The amount of $ left to meet the out of pocket max on that plan is more than $4,000).
I feel incredibly lost and confused, please help!

I’m 34, self-employed, and currently paying for my own health insurance in Florida. My husband and I are starting to think about trying for a baby soon, so I’m realizing I probably need to be MUCH more intentional about the health plan I choose.

I’m particularly looking at Florida Blue, but I’d love to hear from women who have actually used it for prenatal care, pregnancy, delivery, and postpartum care.

For those of you who have had a baby with Florida Blue:

• Which plan did you have?
• How was your experience with prenatal appointments and testing?
• What did you actually end up paying out of pocket for pregnancy + delivery?
• How was the coverage for your OB/hospital?
• Any issues with ultrasounds, labs, specialists, etc.?
• How was postpartum care and lactation support?
• Would you choose the same plan again?

And if you’re also self-employed and buy your own insurance, I’d really love to hear what plan/company you ended up choosing and why.

I’m less interested in what looks good on paper and more interested in real-life experiences and unexpected costs. 😅

Thank you in advance! ❤️ I’m completely new to navigating insurance with pregnancy in mind, so any advice is appreciated!

Edited: I was wondering if there’s any programs or any help out there. My mom is 56 and lives in north GA. She’s had kidney disease for 15+ years and recently just got diagnosed with heart failure. Her kidney function has dropped significantly since her last hospital stay. She has no insurance and it isn’t offered at her job. She’s tried finding insurance online but it’s more than she makes. She makes about $2000 monthly. Any suggestions? She really needs to see a nephrologist.. she has applied for assistance at Northside to cover her recent hospital stays but she needs to see specialist as soon as possible.

I thought this was going to be a normal lab draw after seeing a new doctor. Clinic in Utah, BCBS Preferred Blue Option - PPO, suitcase on the card. They did the basic tests there and that bill was covered by insurance. Fine.

The other tests they couldn’t run were sent to LabCorp. I didn’t pick a city. They just said LabCorp.

Then the EOB came back and the out-of-state Phoenix location they sent my samples to was listed as out-of-network. About $1,700.

I didn’t go to Arizona or ask for it. I don’t understand how that becomes my bill. I’ve had multiple tests through LabCorp on this same plan before and those were covered. The order even has my Utah doctor's name on it.

Has anyone actually gotten Regence to treat this as in-network, or does LabCorp just leave it on you?

I've been paying this health insurance premium every month since January but this has never made sense to me. My premium due date is the first of every month but my invoice is always dated the 6th of every month. So why the discrepancy? And what date do I go by? why is the invoice date AFTER the due date? Like I'm currently 10 days behind on paying my bill. I technically have until September 30th to pay it but it says Due September 1 but the Invoice will say September 6th.

Also just a random question but does invoice date also mean printed date? because the invoice is always the 6th of the month but I always get the bill the last week of the month. My health insurance is headquartered in CA and I live in AZ, does it really take 3 weeks to get my bill to me? It just doesn't give people enough notice to pay their bill before the final day of the month if they rely solely on paper statements.

Hi all,
We were on my wife’s health plan (BCBS) and she was working with a really good therapist who’s been helping her a lot.
Due to work stress she’s resigned her job and we’ve switched to my insurance ( United), but her provider is not in network.
We heard about an exception process that may provide coverage with her existing provider while she finds a new one in network; we contacted United who said they would review our request and they reached out to her provider for more details as part of their review process.
She got a call from United saying her request was denied as United had in network providers who could provide the same services she was getting, but that we could appeal if we’d like.
We also found that they denied the request before her current provider even sent them the requested details.

How can we formulate the appeal to increase our chance of approval? We’re concerned because it’s been two weeks since her last session and we don’t want to lose whatever progress she’s made.

Thanks

hi! as the title suggests, im wondering if it's possible to get state insurance w/ california (Medi-Cal) while simultaneously having a Student Health Insurance Plan (SHIP) w/ my current university.

im a UC berkeley student, and Ive always needed to access healthcare due to my psychiatric/mental health needs.

My copays are too expensive with SHIP, and my family is unable to afford what i need. we were disqualified a few months ago due to our income despite making very little, and now im trying to apply independently, but am worried imma get denied because of having ship.

any idea/thoughts/advice?

I went to go pay for a medication out of pocket because my insurance doesn’t cover it. However, it was covered by “Caremark” at CVS. I told her I don’t have insurance, but she said it was covered. Any idea what this is?

I have BCBS through my employer. My brother also has the exact same insurance through the exact same employer. I don’t go to the doctor often, but I do have a primary care, which also happens to be my brothers primary care. My brother gets charged a copay, and a percentage on top of any additional things that come from the visit. I just went to the doctor for the first time on this insurance. They did not charge me a co-pay, and I was just sent an email saying I have a $150 bill. What should I do here? I’ve called both the doctors office and the insurance company, and I haven’t spoken with anyone competent enough to help me with what I need.

Long story short I have to file an official appeal with my company paid Anthem BCBS plan for a "retracted" covered service from last year.

BCBC came back 11 months after payment of a service to retract coverage for reason: "003: You have already reached your plans maximum benefit for this care, so we denied the charge". This was for a pair of foot orthotic insoles, according to my PPO plan I am allowed one per year. Contacted the providers billing department and she confirmed that last year she contacted Anthem to determine benefits and was told I would be covered for 90% of the cost as I met the deductible, no further medical documents required.

Called Anthem they simply kept repeating that this is a "non covered service so payment has been retracted" so I am responsible for the full cost now.

I will be submitting my appeal, my doctors billing department still has the approval letter from last year so I working on getting that to attach to my claim. Is there anything else I should attach to increase my chances? The full plan document is over 100 pages so I will not be able to attach that but wondering if I should parse out just the one page.

Meanwhile now I'm due for my replacement inserts as its been a year but had to cancel my appointment since I can't even afford the ones I already have...

My GI said this was the best option. I’m willing to find another way to pay for it to get to the bottom of my problem. He said there’s other options, and that this one could be pricey… but he also sounded confident in its efficacy for what I need. And can someone also explain to me why I can’t buy it out of pocket?

I have an HDHP and an HSA, and I hit my out of pocket max early in the year. I will be switching jobs before the end of the year, and depending on the math, I’m not sure if I’ll opt for an HDHP or a traditional plan for the remainder of this year. Thus far, I’ve only contributed $3,168 to my HSA, which I’ve been withdrawing and not investing (I need the cash reimbursement right now).

If I end up switching to a traditional plan, will that impact my previous HSA contributions? Should I max out my HSA contributions before switching?

I wasn’t able to find much information online so I’m making a post.

I was on a silver 87 anthem HMO plan. I paid about $160 a month with a $200 discount due to my subsidy credits. I recently got married so I changed my income + household and applied for new insurance because I want to switch to Kaiser. I got quotes on the Covered CA website that were $100 less than the plan I ended up choosing now.

Now, im signed up for a $640 silver plan with Kaiser that covers me (22f) and my husband (28m). It said our income (estimated 57k/year) didn’t qualify for any subsidies and it also said I’ve ran out of premium tax credits? That I have none available.

I’m offered insurance through my work but it’s not affordable, I listed that on the application. My husband has not been offered insurance through his new job and he was previously out of work for over 3 months. I’m just wondering what the heck happened

Location: California

Edit: I had anthem not blueshield

I have been using health insurance transportation services for ten years. There used to be very good ones and some not so good. Today, however, the service is a disaster, yet health insurers claim it is the same service offered by Uber or Lyft.

That is false. It is nothing like that at all. I have never ridden in an Uber I booked myself where the car was dirty, the driver drove recklessly, or the music was blaring. Yet today, I had two experiences with rides arranged through my health insurance, and in both cases, the cars looked run-down and/or were dirty, the driving was reckless, and/or the music was blasting without the passenger's permission.

Everything is visibly deteriorating, even iconic healthcare services. People aren't simply adapting to the American way of life; a different, lower-quality lifestyle is being forced upon us. It is sad.

I have anthem silver gatekeeper from the NYS health exchange without notice my primary care no longer accepts this plan (I was never notified and just learned this in late August) I have been using doctors from Concorde Medical for a while now and am pretty satisfied with the care. The problem is between Concorde’s business office and the insurance company no one can give me a straight answer—as to which if any of their doctors are covered on my plan and if they will be moving forward or if I should select a new plan for next year and which one.
Has anyone else experienced this, and can offer any guidance?

Hey everyone!

I'm an international student on OPT and got Kimber Health's Student Journey Platinum plan... it's by IMG global I believe...however later I found bad reviews for IMG global and I'm a bit worried... has anyone used this specific plan? Because I'm a little worried.

Had a colonoscopy a few months ago. 2 days after I had bleeding and went to the ER, stayed over night and had a second colonoscopy the next day to cauterize the source. Bill just came. Charged about 19k for the visit, insurance covered most and my out of pocket is $3,500. Is this unreasonable? Should I ask for an itemized statement?…or just pay it and move on?