I will try to make it brief but can answer any additional questions. My wife and I started the process to have a baby. I was insured with Kaiser Permeante (KP) and went to my KP OB. I requested a specific genetic test to be completed (in writing). The DR ordered the wrong test, and instead of the largest panel I received the smallest panel. The records that were sent to me with the results have the name of the largest genetic test despite it actually being the smallest genetic test. I did not realize the error until a couple of months later when my wife and I had selected donors and had to go to a genetic counselor to ensure we did not have any of the same diseases. I was unable to move forward with me selected donors because I did not have the appropriate genetic test. At this time, I was no longer insured with KP and was now insured with BCBS. I went back to KP a requested they proved the correct test, they were unable to without drawing blood again. I proceeded with obtaining the correct genetic test under my new insurance. While waiting for the results both of my two donors were no longer available for purchase and I am now in the process of locating another donor. My wife and I are black, and we are only interested in a black donor. There is a national shortage of black donors and the two donors that we selected were high quality donors (attorney and a doctor). KP has acknowledged their mistake (in writing) and reimbursed me for the cost of the incorrect test. Can I sue the doctor for ordering the wrong test?

Hello, and thanks in advance for any suggestions. I have a 2024 and a 2025 FSA - for simplicity lets say theres 750 in each. We had a hospital stay for the birth of a child, admit on 12/30/24 and discharge on 1/2/25. Total bill 800. I need to pay the 2024 expenses with the 2024 FSA, and 2025 with the new 2025 FSA. Hospital tells me to contact blue cross, blue cross tells me to contact hospital. Neither FSA companies help. Hospital gave a detailed invoice, but the invoice is a mess and impossible for me to split into services given in 2024/2025. The invoice shows the full charges before insurance. i asked blue cross to provide me with what I an responsibke for, split between the two years so I can call and manually charge each FSA for thier respective years… then pray the fsa will take the invoice as a reciept cus I cant get an EOB split by year… This is all a mess, Im exhausted with a baby and JUST WANT TO USE MY OWN MONEY I paid into these stupid FSA’s. To make it worse my employer chsnged FSA providers so I have 2 seperate fsa companies to submit these charges. Any tips?

My husband has a herniated disc and possibly arthritis, and we’ve been putting off going to the doctor because we’re confused and stressed about what our insurance (Cigna Wellfleet Student) will actually cover. We’re in Rhode Island. From what we can see, the MRI isn’t fully covered under our plan, and possibly other services aren’t either. A regular doctor visit would cost us about $50 out-of-pocket (not sure about the exact term), which isn’t awful, but feels kind of pointless if we can’t afford to get the necessary tests like MRIs anyway. What’s really throwing us off is that a friend of ours, another student with the *same exact plan*, broke their foot, went to the ER, got an MRI and whatever else was needed, and only ended up paying $100 for the ER visit. That’s it. We’re super confused. We’re also hesitant to call the insurance company because we’re scared they’ll be vague or misleading on purpose, or try to hide what’s actually covered to benefit themselves. We feel really stuck and just want to make the best decision for his health without going broke. Has anyone had experience with Cigna Wellfleet Student plans, especially in RI? Any advice on how to navigate this or what we can do to get clearer answers?

Hi everyone, my 77 year old dad is visiting me in May. It's his first time in the US. He has a COPD condition and we recently came to know from his doctor that he needs supplemental oxygen. He had to do a bunch of tests (spirometry, Hypoxic challenge) to qualify for it. The thing is once he is here and it's time To go back, the airline needs him to redo the tests that he's already done. I talked to INF and it looks like they only cover an onset of a pre existing condition. But, this counts as ongoing care. Can anyone recommend an insurance that will be helpful in this case? Thank you so much.

nybody here have mediCal? (Govt free medical insruance in the usa for ppl under age 65 and unemployed or flat out broke). My uncle generously cash paid for my mcas doctor. I have a script for cromolyn sulfate, can I use the script at the pharmacy and will medi-cal pay for the meds? Usually people with California state Medi-cal for those under 65 are unemployed or too sick to work but not yet documented and broke like me, so qualify for medi-cal, but those doctors are the worst and most incompetent. My uncle paid a mcas doctor to see me, abd I got a script for cromolyn sulfate. Usually medi-cal will pay for my meds even if i saw a cash pay doctor. Or is it a situation whereby I need to prove that I used lower level meds and they didbt work before I get approved from cromolyn sulfate? Remember I tried to get triamcinolone cream under private insruance (blue cross blue shield), but they said i had to trial lower level creams and then fail those 2x first. Making me waste life energy and jump thru hoops so insurance company can save 20$.

My wife has started seeing a new therapist who she seems to really like. The therapist is out of network for our insurance (Cigna) and I think does only self-pay, but issues a superbill at the end of the month that we can submit for reimbursement. This superbill contains her NPI number but not her TIN. I have submitted claims with these superbills to Cigna but they have been denied due to lacking a TIN. After seeing the denials I googled and found that this provider is a sole proprietor therefore her TIN is actually her SSN, and that it is a relatively common practice for solo therapists to be structured this way instead of through an LLC. If she declines to provide a TIN to our insurance company is our only recourse finding a different provider? I’m not going to ask my wife to switch but just want to understand the lay of the land.

Non-working graduate student recently approved for Medicaid, but prior to this I had purchased my schools shitty student coverage. Obviously, the coverage for Medicaid beats the school insurance. I called the school insurance and asked them if I could cancel because I want Medicaid as my primary insurance but they told me that is not possible and won't give me a pro-rated refund. I paid $2000 at the beginning of the school year for the insurance for the whole year coverage, and I figured they would be able to refund me a portion of that since I wanted to cancel, but they seemed appalled I even asked to cancel and told me to kick rocks. It wasn't even the insurer, it was the insurance broker who told me this. Am I stuck with school insurance as my primary and Medicaid as my secondary? I don't want to just stop using my school insurance and start using Medicaid as that would technically be insurance fraud? Sorry if this is a strange question; I am not well-versed in this world. Thank you for your time

I did my due diligence and found a provider listed on the BCBS website listed as in-network. I verified with insurance and the whole nine yards. However, when BCBS adjudicated the claim, it was processed as OON to my surprise. When I questioned why, I was told the provider used a different NPI that is OON. In all seriousness, how is a patient supposed to know what NPI a provider bills under? Do I have grounds to appeal the OON determination or should I ditch this provider and find someone else?

I’m going to lose my mind. I feel like I’m going to have a panic attack. I have Aetna, yet I still owe $6000 on an er visit after I had complications with my gallbladder surgery. I haven’t even gotten the bill for my surgery yet. I literally cannot afford this. Insurance is through my work and I didn’t have a choice. My deductible is 6000 and yeah I’ve MET that now, but I still can’t afford $6000!!! Why is health insurance in the us so bad. I’m literally going to cry Is there ANYTHING I can do to lower my bill? I called the hospital and they couldn’t do anything to help

I'm starting a new job in a month. It's remote, and I live in southern Arlington, VA. The health insurance the company provides is Blue Cross Blue Shield of Michigan, because it's a Michigan based hospital. My to-be manager (someone I know from a previous job) lives in Arizona and he said the pickings of doctors have been lacking due to it being BCBS of Michigan and he's in Arizona. I'm wondering if anyone has had similar experiences? Should I take the BCBS of Michigan health insurance (which doesn't cover anything birth control related so I'd have to get something to supplement that) and hope for good choices of doctors in Arlington, VA? Or go onto my husband's insurance with Kaiser Permanante even though it's more expensive?