Hey all, I’ve been having issues with my insurance trying to approve a surgery. My surgeon submitted a prior authorization and they denied it. They resubmitted it with a different diagnosis to meet the criteria. They usually take 5-10 business days. But within 48 hours I checked my UHC account and it said “cancelled”. What does it mean when it’s been “cancelled” and not actually denied? I have United Healthcare through my mom’s work. Thanks!

So a few months back my secondary health plan changed because I made too much money to stay on the plan that covered the payments which my primary insurance didn’t cover for my therapy appointments. Today, I get a call from the therapist saying a few things: They didn’t have my secondary listed anymore(not sure why), my insurances United and mass health were not aware of each-other, and now I owe $550 for past appointments. What’s really annoying is when I had this insurance plan change, I made sure to talk to my therapist and office asking to make sure I was still covered, and I don’t remember if they gave me a *clear* yes or no, but I remember being told that it should be fine. My personal line that I drew for myself with therapy is I would stop going the second I had to pay a dime out of pocket for it(it’s been almost 2 years since I’ve started) So my question is there any legal repercussions if I don’t pay a dime to this debt? What options should I explore, if any at all. Do I just make a payment plan for 1 dollar a month? lol Obviously I feel very wronged by this, and insurance companies won’t give a damn about me telling them “oh no I thought I was covered”. Thanks for any input.

Long story short, I recently got a grant for my son who has autism spectrum disorder and was able to find a provider who had social skills therapy for him. The grant will reimburse me costs 100% however they need a copy of the EOB. I found a provider who was out of network but was the only one offering this therapy in the time period I needed it. She was upfront saying that we would have to file our own claim which I have no problem with. She provided the superbill and all of the codes. Well today I logged into UHC to try to submit a mental health claim and the form is not available, then I called them and they told me that I cannot submit my own claim. I told them that my provider does not file claims but they were insistent on saying that the doctor would have to file them. Is this a common practice? I am just frustrated.

Hello. In December 2024 I enrolled in health insurance with United Health care through my employer during open enrollment. Benefits were to begin 1/1/2025 and my premium was to be $54.44. I noticed on my recent paycheck that my premium had more than doubled. I never received notice of this premium increase and only realized it had happened because my paycheck was smaller. I called them and they said the increase was because they "recalculated my information and saw an adjustment was needed." I demanded they cancel my plan, as I had not agreed to this premium. They said I wasn't allowed to cancel until the next open enrollment period with my employer in December 2025. They said they would open an appeal on my behalf and created a ticket, but I’m doubtful it’s going to make a difference, they will likely just reiterate what they already said and not allow me any recourse. Are they allowed to do this? Do I have any options in this situation or do I just have to accept that they can charge me whatever they like throughout the course of the year? I was not aware rates could change mid-policy like this. I am 48 and healthy. I have a nearly $10,000 deductible, and don’t go to the doctor for anything outside of my yearly checkup because I cannot afford to pay for anything out of pocket. I’ve also stopped taking prescribed medication because I don’t want to pay for that out of pocket either, and I can get by without it. It’s crazy to me they’re allowed to do this. Apologies in advance if I have posted in the wrong place.

So like the title says I had 2 doctor visit back to back days. One I saw the PA and the other I saw the NP. But the medical claim with my insurance says I saw the doctor. I received a bill from the clinic stating I owe an additional $76.93 for the PA and nothing additional for the NP. Both doctors are from same clinic but different specialties. I reached out to my insurance and they said it was both bill coded as me seeing the doctors. Is this correct? I reached out to the billing department of the clinic and it’s been almost 2 weeks and they haven’t gotten back to me yet. Is this correct? I paid $220.63 both times (I have a high deductible plan) I think. I don’t have a copay - I pay for everything my insurance doesn’t cover(which they don’t cover very much) If you have more questions to help answer this let me know. In the last month I’ve spent $1600 in medical and I want to make sure I’m being billed a surplus amount. Edit- I’m 29F from Texas and I’m insured through my job with UHC

I got an advertisement from my insurance, UHC sent to my email about a program called Real Appeal. The title said “Reach your weight loss goals now, at no additional cost” so I signed up and made an account. It looks like UHC denied the claim and I now owe $162.23. I set up a Teledoc appointment but missed it before looking at my claims (my mistake I know). I missed the appointment and haven’t rescheduled. I’d link the email given but not sure how.

I had horrible customer service experiences with United Healthcare this past week. Horrible enough that I want to send a complaint to the appropriate people. I have unsuccessfully searched all over for an email address - I can't stand the thought of another phone call with them. Does anyone know the email address?

I am wondering if anyone has figured out the best insurance available in ohio that is budget friendly? I use to have medicaid but they kicked me off a few months ago and ever since I've been on this healthcare marketplace insurance with united healthcare but in still struggling with paying it and living my life lol... I have omnipod and dexcom g7 and they barely cover that... I'm also wondering if it would help to find separate insurance from my spouse? Or just to stay on the same insurance?

UPDATE: I called this morning and apparently the post authorization did get approved without my knowing and without updating in my online portal. It's still showing online that I owe the full amount but the employee I spoke with said to ignore those charges and wait for a bill in the corrected amount of $333.87 which is much more palatable. Major thank you for everyone's input!! It was late and I was getting very anxious about it, I seriously appreciate everyone's comments. Hopefully there won't be any more mishaps and I know better moving forward to make sure preauth gets sent. Recently I had a colonoscopy at the suggestion/request of a gastroenterologist for issues I've been having. This was my first time having any kind of outpatient procedure and my first time dealing with marketplace health insurance (United Healthcare) on my own. I did not know that prior authorization was a requirement for this procedure. Prior to scheduling the procedure I spoke with UHC about coverage and was told I'd only be charged the copay because it was in network. After the procedure I found out the medical office and hospital failed to request authorization and did the procedure anyway, now I'm being charged $5,000+ for the colonoscopy because of it. I didn't know I needed authorization and moreover it was the medical facility's responsibility to get that, and NOT perform the procedure unless it was granted. Am I mistaken? Has this happened to anyone else? What are my options? I've already called the medical facility to submit a post-authorization appeal but it seems to be denied as well. I'm at a loss and feel entirely screwed over, would love some advice!

This is a weird problem to have. My therapist is not in-network (I have United Healthcare/UMR) so I pay her and submit the bill to UMR for reimbursement. For about a year, my insurance has usually said she is in-network, and reimburses me for about 50% of the cost (100% of their "adjusted cost" which is half of what I actually pay her). I mentioned it to her but she said she has never been in-network, which I believe - it would be pretty dangerous for her to try and take payment from both me and the insurance company. So I figured it's fine, if my insurance says she's in-network when it comes to reimbursements then I'll believe them. The reimbursements this year are now 95% of the actual cost (so they're paying me back more now). And I'm really starting to wonder, is it my responsibility to say something to the insurance company about this? Is there a chance that they ask for some of this money back later? Thanks for your advice