So I’m having issues with my mother’s insurance plan through United Healthcare. It’s a family deductible plan being offered by her job here in Florida. All people in this story are covered by the plan. My dad went in for a procedure, which they were contacted about prior and informed us that they would cover. It was billed to them on April 26th. However, they then disputed the claim afterwards, despite us alerting them before the fact. The cost of this procedure would’ve met the deductible, and thereby changed our out of pocket costs.
After this, I have been going to physical therapy with an in-network provider, and paying the out-of-pocket costs, despite thinking the deductible was met, only finding out two weeks into the treatment what the issue was. At this point I had paid 4 times. I will go 12 times in total, per doctor’s orders. I also have other appointments throughout the month of June, and I have no idea when they will approve my father’s procedure from April, and therefore have no idea whether I’ll be paying $10 or $100. The receptionist at my PT office told me that I can submit the receipts to my insurance company and ask for reimbursement, since the dates would match up as to when the deductible was supposed to be in effect, and they should’ve covered the treatment, but did not.
I called the insurance company, and was told that I would not be able to be reimbursed the costs of my PT that was paid for before the deductible was “met,” even though it hadn’t been met because of a clerical issue on their side. I’m understandably frustrated by this. I’m curious as to whether this is common-place in the market, or if my insurance is, in fact, screwing me over. They have been playing games with authorizing other procedures, notably an MRI which was entirely out of pocket regardless of if the deductible was met or not, and causing massive hold-ups and stress everywhere. I just want a second opinion, really, because this is causing a lot of stress.
submitted by /u/SyddiSheep
[link] [comments]
So I’m having issues with my mother’s insurance plan through United Healthcare. It’s a family deductible plan being offered by her job here in Florida. All people in this story are covered by the plan. My dad went in for a procedure, which they were contacted about prior and informed us that they would cover. It was billed to them on April 26th. However, they then disputed the claim afterwards, despite us alerting them before the fact. The cost of this procedure would’ve met the deductible, and thereby changed our out of pocket costs. After this, I have been going to physical therapy with an in-network provider, and paying the out-of-pocket costs, despite thinking the deductible was met, only finding out two weeks into the treatment what the issue was. At this point I had paid 4 times. I will go 12 times in total, per doctor’s orders. I also have other appointments throughout the month of June, and I have no idea when they will approve my father’s procedure from April, and therefore have no idea whether I’ll be paying $10 or $100. The receptionist at my PT office told me that I can submit the receipts to my insurance company and ask for reimbursement, since the dates would match up as to when the deductible was supposed to be in effect, and they should’ve covered the treatment, but did not. I called the insurance company, and was told that I would not be able to be reimbursed the costs of my PT that was paid for before the deductible was “met,” even though it hadn’t been met because of a clerical issue on their side. I’m understandably frustrated by this. I’m curious as to whether this is common-place in the market, or if my insurance is, in fact, screwing me over. They have been playing games with authorizing other procedures, notably an MRI which was entirely out of pocket regardless of if the deductible was met or not, and causing massive hold-ups and stress everywhere. I just want a second opinion, really, because this is causing a lot of stress.
submitted by /u/SyddiSheep [link] [comments]Read Morer/HealthInsurance