Using a throw away account... I have Kaiser through work. Since I've been on my current plan for the past 3 months, Kaiser has terminated my insurance on the last day of the month. According to the payroll company (ADP), my benefits are valid and from what I can tell, dental and vision (not through Kaiser) are also valid. I don't understand why this keeps happening. The only thing I can think of is that it's a Northern California plan and I live in SoCal. I lived in SoCal when I selected my plan and was told it shouldn't be an issue, but now I'm questioning that. Last time it happened HR confirmed that it shouldn't again, but here we are. This is a tremendous hassle every time it happens since both my husband and myself need to have our SoCal and NorCal medical record numbers linked and then it takes several days before we can access anything on the website in our region.  Does anyone have insight into how or why this keeps happening? I'm at my wits end.

Last month, I was laid off. I opted into COBRA with a start date of 04/01. The paperwork was sent to me last Wednesday, I elected into it Thursday, and paid my premium on Friday. Today, I logged into Cigna and it's showing I'm inactive with no insurance. After a few hours of customer service between the COBRA intermediary (WageWorks), they assured me I'm active and it takes a couple of weeks for Cigna to process. They sent things over yesterday and said my insurance would be dated 04/01. On the chat, Cigna wasn't able to help very much (which I understand). Is there anything else I should work on during this transitional time? Or, have others had success with waiting and letting the process work itself out? Thank you all so much!

I have read some prior threads for this but they are from a year ago and I'm curious if there have been any changes. Background: I have had UHC and used Optum for my specialty pharmacy for years. My specialty medication is a biologic with no generic equivalent. The manufacturer provides me with both a copay card and a payment card. My deductible has consistently been met in January every year using the payment card, and then the copay card picks up the copay for each month for the rest of the year. Situation: This year, the manufacturer payment card was processed as usual and applied towards my deductible, however, they went back a few weeks later and reversed it from my deductible. When I called them, they said nothing has changed and the payment card, as a form of manufacturer assistance, cannot be applied towards my deductible, despite that having always been the case. Based on what I have read about an HHS ruling, they are required to apply this towards my deductible as there is not a generic available. I filed an appeal and was denied. My employer plan is likely self funded, but from what I have read, that should not matter. Has anyone gotten a resolution to this issue?

My husband works for a company headquartered in Virginia, though around 1/4 of their staff are in NC. They recently switch their health insurance from Cigna to Sentara, which I’m sure is great for the Virginia folks but our nearest in network hospital is now a 1.5 hour drive from here. This seems like it would violate some sort of MEC requirement? But I don’t know enough to know and my husband has not been able to get in touch with HR for answers.

ive asked anthem blue cross five times and not getting anywhere. my mental health is completely covered. i made an appointment to do telehealth and they said i have a copay of an office visit. the insurance company offers telehealth through their own app online. what i want to know is - how can i find info on the telehealth offerings that my insurance cover. am i wrong to assume they should cover the entire cost since its under mental health. do insurance companies have different rules for telehealth? have they come up with different rules and why cant i just read about the rule? they keep saying send them the cpt code? so would it be normal that they cover mental health one hundred percent but telehealth for mental health is the cost of an office visit?

My insurance denied two claims. I appealed it and they denied my appeal. I received a letter letting me know I can request an external appeal through my employer. I submitted a letter, signed doctor's letter of medical necessity, signed medical records release form and a few clinical studies showing effectiveness of treatment. I received a letter in the mail today from Network Medical Review Co. The letter states: NMR has received a request for external review and has been notified from the plan that the request is eligible. NMR has accepted the request for external review. You, the claimant, may submit in writing to NMR, within 10 business days following the date of receipt of this notice, any additional information that you wish NMR to consider in reviewing your claim. NMR will review all of the information and documents timely received, and will provide written notice within 45 days after NMR receives the request for the external review. I'm not sure if my employer would send everything that was sent to them or if I have to send everything all over again. I sent them the original doctors letter of medical necessity so all I have is a copy.

I switched to an HMO plan, and all doctors at the practice I go to accept my insurance, including my PCP. However, the PCP I was seeing is relatively new, and because of that, they don't show up on the list of providers when I go to assign my PCP with my plan online. I remember having this issue a year ago when I tried seeing them for the first time (I wound up having to wait until my job gave me an EPO plan). I love my PCP, and don't want to have to choose a new one after being with them for a while. Is there anyway to get my insurance (Anthem) to update their list? Or would the doctor have to go through a process on their end?

\*EDIT: I've been corrected by a few people-- The person I was interacting with was probably a medical technician/phlebotomist, not a nurse. Sorry for the mix-up in the title. Hi all. I have a problem, and I'm not sure what to do. Earlier this week I (24F) went to a Labcorp office to get blood tests done in advance of my hematology appointment (this is something I have to do multiple times a year). When I got there and was checked in, the medical technician\* asked me if I was there on the orders of "Doctor Smith" (fake name). I told her that while Doctor Smith was one of my doctors, I was actually there at the request of my hematologist, "Doctor Johnson." The Labcorp worker told me that there was nothing from Doctor Johnson's office in the system, and the request from Doctor Smith was the only one she could see, so it HAD to be the right one. Since she was the expert, I assumed she was right and went along with it. Well, that was a bad move. Instead of giving me the tests I needed, the medical technician\* redid ten completely unrelated tests that I had already gotten done in August. Now I found out that they're planning to charge me $220 for the incorrect tests, plus I need to go back and have more blood drawn because I still haven't done any of the tests I need for my hematology appointment. Is there anything I can do to not pay this initial $220 bill? It really feels unfair to me, mostly because I already had to pay an identical bill back in August when I got these tests done the first time. I've already called the Labcorp, my insurance, and the hematologist's office, but all of them seem really unsure about the situation. Which one should I keep calling? For extra context... I live in Maryland and make roughly $65k a year. I'm on my dad's insurance.

I work for an employer that does Cigna healthcare with three tiers, but the costs for all three plans are similar to the three tiers that Blue Cross Blue Shield offers on the open market. I currently have a premium plan with BCBS for ~$1400/month and my employer’s premium plan is also ~$1400/month. How do companies get away with “offering” healthcare insurance that isn’t subsidized at all? This seems very disingenuous

I had a pre-op call with my hospital today prior to my bilateral salpingectomy (preventative birth control) procedure next week. I have a new Aetna plan with a $2k deductible, so it didn’t seem crazy when the hospital said I owed $2k. But now I’m hearing that my procedure should be free under the ACA. I was told I’ll get my receipt for the charge at my pre-op appt on Friday. Any chance of me getting this money back if I dispute? Can I do a chargeback on my card?