Hi! I had a specialized lung surgery a few months ago that the surgeon I worked with files a gap exception for. I signed a contract that said I'm not allowed to reach out to my insurance or file anything without their express written consent and that they will handle all of the billing to get my gap exception approved. The office required me to wire $20,000 upfront for the main surgeon along with an additional $6,000 for the assistant surgery that they chose and required to work with the main surgeon. I signed a contract that says if they receive ANY money from my insurance that is in excess ..read more

The plan is the same provider but it's no longer a PPO. Essentially I lost my job and I can't afford the PPO option. I've never had an HMO plan before so I am clueless on how this works. submitted by /u/rfcaballes [visit reddit] [comments ..read more

Recently got out of the military and I'm about to start working as a contractor. I'm within the window for Qualifying Life Event (Idaho) and I'm working my way around the marketplace. I'm still very confused at what I'm supposed to do if I plan on traveling every 3-4 months. I'll be making 89K, housing covered, no spouse or dependants. It looks to me like anything decent will run me 360+ a month but I'm concerned about being out of the state. I don't have any persistent issues now but I understand going without insurance is a bad idea. Do I just grab an HSA? Everything else seems to be orient ..read more

All anyone heard of my previous post was "Give me your stories of when insurance kicks in." You all missed the point of my post. I don't want to use my insurance unless it's a major procedure or emergency. I want to use insurance like we were SUPPOSED to in the 80's and 90's. I want to only use it in the event of a major medical event. The only major medical treatment facility in my area is REQUIRING me to use insurance because "We have a contract with BCBS." I just called again to get a good faith estimate. The good faith is $154. The paper that was provided at the desk said "Insurance bille ..read more

Hi! I am 25(f) and self employed. No longer qualified for Medicaid. I’m healthy but do have epilepsy. I am on medication for it and see a neurologist regularly. Are there any providers that are better than others? What are normal price ranges for individuals? submitted by /u/Sufficient_Ride_3880 [visit reddit] [comments ..read more

Hi folks, my elderly father took out health insurance for my sister a few years ago. She got her own insurance shortly after, but he apparently never cancelled the original policy and has been paying for it ever since. He has memory issues and doesn’t remember any of this, and my sister had no idea this policy existed. I know it’s a long shot, but is there any way we might get any sort of refund on the policy payments? No claims have been made, and we’ve never heard from the insurer about any sort of renewals. I know my father should have noticed the monthly charges, but he didn’t. submitted ..read more

We are expecting baby in ~9weeks. Since we lost our health insurance through our employers (different companies and we both lost our jobs separately - it’s a double hit for us), we are looking at healthcare options through marketplace or cobra. What’s type of insurance would you recommend to get? For hospital bills such as the birth and care after for mother and baby, what matters more: deductible or oopm? My understanding was oop mattered because we will likely hit it with the hospital stay, but how does the deductible play a role? We are based in Nj. Any information or suggestions/ advices ..read more

Hello I have been a federal employee now for 8 years and I have always had Blue Cross Blue Shield as my health insurance I currently live in the mountains of Colorado and my primary doctors and Hospital are located near me that I need to use for my medical needs I recently got a letter in the mail from Blue Cross Blue Shield telling me I only have until June before my primary physicians are no longer covered by their company my question is will HR help me switch to another Insurance Company outside of Open Season because of this? submitted by /u/MattfgclG [visit reddit] [comments ..read more

I’m losing sleep towards this so bear with me. I went to labor and delivery on August 2022 and at the time they didn’t ask me for insurance or anything so I assumed (my mistake) that they had it on file. Fast forward to March 2024 I get a collections later saying about a debt I never paid. I never received a bill from the hospital and I gave birth there two months later and was able to receive that bill! However this particular one, they had sent to an address that I haven’t lived in in over 15 years! And to top of that they were billing an insurance that I also haven’t had in 15 years! So no ..read more

Hi all! I need help navigating a situation that has gone on WAY too long: 12/22/23 - I visit a new PCP for a slew of problems. My bill comes to $595 (plus a $30 copay) for the following 3 services: Initial preventive medicine new pt age 18-39yrs, Office/outpatient visit est4, and Brief emotional/behav assmt. Provider submits claim to insurance. 12/29/23 - Insurance rejects claim due to "Missing or invalid information." 01/13/24 - Provider resubmits claim. 01/17/24 - Insurance rejects claim due to “Contact ID is Not On File or Member is not Active on Date of Service.” 03/12/24 - Provider resub ..read more