Hi everyone,
Not sure where to go with a back-and-forth I’ve been having with my former health insurance company, so thought I’d seek some crowd knowledge from reddit. No responses from the main insurance sub, so trying here.
Last year, I made some mental health visits for a few months with a doctor that did not take insurance. My insurance policy (Florida Blue – linked below) at the time stated that I was eligible for up to 50% reimbursement for out of network visits.
Because this was during the height of the pandemic, my doctor was not holding in-person visits.
When I submitted my reimbursement claim, I was denied because my visits were considered “telehealth” and only in-person visits were eligible for coverage. I have appealed twice now on the grounds that it was not my choice to have remote visits, it was just a result of current times/policy (I even included a note from my doctor testifying to the policy). The insurance company is now telling me I have exhausted my appeals.
Any advice? Am I in the right here and do I have any options to take this further?
This is an overview of my old plan.
TLDR; Denied out-of-network reimbursement because my visits are being classified as “telehealth” when I had no choice of in-person due to pandemic policies.
submitted by /u/Captain-Scrummy
[link] [comments]Hi everyone, Not sure where to go with a back-and-forth I’ve been having with my former health insurance company, so thought I’d seek some crowd knowledge from reddit. No responses from the main insurance sub, so trying here. Last year, I made some mental health visits for a few months with a doctor that did not take insurance. My insurance policy (Florida Blue – linked below) at the time stated that I was eligible for up to 50% reimbursement for out of network visits. Because this was during the height of the pandemic, my doctor was not holding in-person visits. When I submitted my reimbursement claim, I was denied because my visits were considered “telehealth” and only in-person visits were eligible for coverage. I have appealed twice now on the grounds that it was not my choice to have remote visits, it was just a result of current times/policy (I even included a note from my doctor testifying to the policy). The insurance company is now telling me I have exhausted my appeals. Any advice? Am I in the right here and do I have any options to take this further? This is an overview of my old plan. TLDR; Denied out-of-network reimbursement because my visits are being classified as “telehealth” when I had no choice of in-person due to pandemic policies. submitted by /u/Captain-Scrummy [link] [comments]Read Morer/HealthInsurance