My BCBS refused to pay any of my blood work. I was referred by my doctor to go to a specialist to get blood work done, over 6 months ago. Now I got this bill in the mail from Quest and found my EOB. They coded it 002 as “we do not cover experimental or investigational procedures” Ok…isn’t the entire point of blood work to investigate? Anyway, should I call my insurance or the specialist to appeal the bill? Any advice? This has never happened to me before. Thank you!

I just had my first mammogram (just turned 40). My breast are extremely dense. Otherwise, normal/negative mammogram. I did the ABUS and now they want me to come back for additional ultrasound due to artifact versus true mass. At this point, I don’t really trust the ultrasound because of how dense my breasts are. The ultrasound lady kinda laughed at how white the screen was after she did the imaging. So here is my question: has anyone with extremely dense breasts ever gotten a screening mri of breast covered for extremely dense breasts? Not really counting on being able to do it as a screening test at this point because I’m probably now only able to diagnostic tests due to the ABUS findings. Asking for future testing mostly. I called BCBS and they were useless. I asked “if I have extremely dense breasts and my doctor puts that as the ICD:10 for a screening mri of breast will it be covered?” It lists screening mri of breasts as covered on my EOB. The lady on the phone couldn’t answer me. Appreciate any insight. Thank you!

Location: Michigan At a loss here. Just received a statement from my health care provider that BCBS denied my iron infusion from January and that I owe $11,000. I had iron deficient anemia during my pregnancy and iron pills didn’t do anything to raise my levels so my doctor ordered iron infusions. I didn’t think anything of it as during my first pregnancy in 2023, I also had iron deficient anemia and my iron infusions were covered by my insurance but it was through a different health care provider. BCBS is claiming that the treatment I received for iron deficient anemia isn’t covered. The procedure was coded as q0138. Do I appeal? Do I call my health care provider and see if they coded this wrong? Owing $11k for something that’s been covered before is stressing me out. I never would have agreed to iron infusions if I had known it would be denied. I cannot afford an $11k bill…

I have medi-cal through anthem blue cross in association with LA care health plan. I have never had Medicare part B. I had a ultrasound in october 2024 which was approved by my primary care provider. I just got a letter today from the centers for medicare and Medicaid services, fargo ND. It is saying that the ultrasound was not approved and i may be billed 220$ It also says i have not met my part B deductible of 240$ Again, i don't have medicare part B. Im not experienced with these insurance issues. I dont know if medi-cal already paid this or not, it's been almost 6 months. Is this medicare preparing to bill me for services already paid by medi-cal ? Thank you, input appreciated.

i hope this is the right subreddit for this! i just found out that my dietitian for an ed is no longer fully covered by insurance and my weekly appointments are now going to cost 90 dollars. i’m wondering if there’s a way to get insurance to continue to cover? like could i have my primary care physician or psychiatrist refer me to a dietitian? tbf i am not as aware of how insurance works as i should be so i have no idea if its even a possibility. edit for clarity: my insurance has not changed. i live in michigan and use blue cross blue shield. i was unaware that they will only fully cover a certain number of appointments and i have reached that number.

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?

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?