Hi! So I've enrolled into healthcare marketplace back in November, and I've hit a major health issue since then and my current healthcare provider is absolutely helpless and don't seem to care enough to help me ( I have Kaiser Permanente). Is there anyway I can switch insurances past the deadline (I know its so late now) but I'm quite fed up, and super frustrated. Any advice helps! Thank you for reading\~

I’m sorry if this doesn’t make sense or for any errors, I am in shock. I have a state specific BCBS under my parents (meaning I’m the dependent). Last year after I moved out of state, they told me that they cover providers out of state. I’ve never had an issue with this. Now, I’m getting claims that I owe $700, $2,000, etc for every visit I’ve had this year (I have a chronic condition so, lots of visits). Turns out, our plan doesn’t cover out of state anymore. Were any of us informed of this? Haha no of course not silly! When did it start? Last year, ya know, when they were still telling me I was covered. I found these providers on the insurance website which is the big kicker & I had no idea bc I assumed “found on insurance website + office taking insurance + no bills yet = I’m covered”, but apparently I’m just that stupid. I even called to ask about providers. Now I owe $6,000+ that I don’t have. I’m in my 20s & in constant pain. I can’t afford not going to work despite hurting & not being able to breathe & now it seems like I can’t even afford living. They said the only thing I can do is submit a bunch of appeals saying I didn’t know about the policy change. I can’t go see doctors anymore. My job doesn’t provide insurance. If I want a plan that covers my health problems, it would be a minimum of $400/month which is insane. I don’t know what to do. Anyone else experience this?

I'm a 24 year old male in NE with UnitedHealthcare. I make approximately $82k gross. I've had UHC for a few years now and have always done my yearly preventive checkup, which was always 100% covered until now. I've contacted both my provider and UHC trying to figure out why I'm suddenly being billed. When I check my claims, the labs given were mostly covered by my plan, with small amounts for each service charged to me. * Labs: * 80061 LIPID PANE, * 84439 ASSAY OF FREE THYROXINE, * 80050 GENERAL HEALTH PANEL, * 81001 URINALYSIS AUTO W/SCOPE, * 36415 COLL VENOUS BLD VENIPUNCTURE * If I have to pay my deductible before labs being covered, why are they covering ~77% of my cost anyways? If they're 100% covered, why do I have any deductible? * My insurance says it was coded incorrectly, but my provider says it was correct. * I asked my insurance to compare my previous years' coding to my current claim, and they said it was the exact same thing. CPT and Z codes. * I was given a follow-up call and sent [this pdf](https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/preventive-care-services.pdf) which details which codes are considered preventive, and I think I see my labs aren't? But I don't really understand what it all means, and either way it's the same coding as previous years, so why were they covered before but not now? Why cover them partially? * If the guidelines have changed, am I responsible for tracking that and telling my doctor what to do at my yearly checkups? * Is there a super simple explanation for why I'm being charged? Does the insurance have a max payout which the provider over-charged, leaving me to pay the rest? How can I tell? Thanks, this is all very confusing and frustrating to deal with. I don't know much about insurance or anything, but I feel like this is wrong somehow.

Over halfway through pregnancy. Blue Cross Blue Shield of Texas on Monday stopped the majority of my local hospitals from being in network. Was told to fill out a continuation of care and I would be fine. I’ve called BCBS customer service and have received either non-answers, or have been told that since I’m pregnant, the only thing they will cover is my OB’s costs. That means: labwork would be out of network, my hospital/facility fee would be out of network, my child’s care would be out of network once they are born. My OB only delivers at the out of network hospital system. I’ve been trying really hard to find someone that is in network in my area to take me as a new patient due to being so far along. Any insight?

I have a BCBS of Illinois community health plan, and I've been looking to find a dermatologist that's in network and when I go on the website look under the "in network" tab, everyone I call says they do not accept my insurence. This isn't the first time I've dealt with this either... Even when I call and get a list from that it's the same story. Am I doing something wrong? By the sounds of it a lot of the offices I call make it seem like they asked to be removed from these lists and never were.

I'm going to keep this as short and to the point as possible.. Before my job forced us to change insurances, my BCBS plan had an all inclusive copay, meaning when I visited my specialist(or anyone for that matter), I paid $70. That was it. I had been getting bimonthly infusions that cost just under $10,000. All covered under the $70 copay. Rad. When we were forced to switch, we had our choice of hundreds of plans. I tried SO DAMN HARD to get insurance plans to tell me what my infusions would cost under their specific plans and got stonewalled every step of the way. I had all of my billing codes and everything. Long story short, I ended up choosing one that I believed had a similar setup to my last plan: all inclusive copay. Turns out, it is, but they are trying to bill me for the prescription used during the procedure($9,000+). I have to pay for that($300 specialty tier med) AND the copay. They couldn't explain why that is a loophole. My infusion is a buy and bill, which means it is billed under MEDICAL, not prescription benefits. What am I missing here?? TLDR: "All inclusive copays" have loopholes apparently?

Anthem blue cross blue shield is trying to charge my 20% coinsurance from the bill total rather than the allowed amount. Is this correct?

I am scheduled for surgery next week with a specialist. I’ve waited a very long time to get this care and am chronically ill from my health problems. I received notice from the hospital billing department today that in fact the hospital is out-of-network with my insurance. This is after at least 6 months of appointments at this hospital and with this surgeon’s office. My insurance was billed for the other pre-op appointments. The billing office informed me today that I would have to pay about 49k up front to even be seen by the doctor for the surgery at this point. I pressed both my insurance and the hospital as to how this could happen. According to the hospital billing office, they had my insurance numbers but not my card on file (I’m quite sure I gave them my physical cards at one of my in-person appointments). They said someone had entered the wrong plan into the system (one that was covered by the hospital) and just discovered this. Something feels very wrong to me, not to mention the psychological stress of having been preparing for a hopefully life-changing surgery that is likely to be off the table. I have the option to file an out-of-network gap exception or use another recommended surgeon, but I am enraged that this mistake was made. I don’t understand how the hospital could just now find out that my insurance is out-of-network. Can anyone advise—is this fishy? What might I do to get my surgery next week? My FMLA is approved, my friend paid money to fly to stay with and take care of me, and childcare and meals are organized. I find the whole thing unacceptable but don’t know how to advocate for myself. My plan is Highmark Blue Cross Community PPO.

My husband had a emergency surgery for his appendix on February. We just received his EOB and it says denied because the provider didn't pre authorized the service and that we shouldn't be billed for it. The bill is $37,000. Our insurance is through Aetna. What does this mean? Do we really not owe anything? Or will the hospital still bill us? TIA Unable to call insurance since they are already closed. Edit: The hospital is in network.

Is there a difference in how United Healthcare covers their insureds if it’s through the workplace vs the ACA (marketplace)? I currently have UHC through my work and it’s not as bad as people say. I’m thinking about retiring early and getting UHC via the marketplace but I’ve been reading there is a huge rate of denials or delays for basic care. Is there a difference between the two? Anyone had UHC via their work and then switched to the ACA UHC?