I started doing telehealth therapy in Oct 2021 when my health insurance changed due to my parent switching jobs. Since then I used to do therapy twice a week bc I was told that in-network telehealth was fully covered no copay or anything. That was true up until 2022.
So far this year I have had 10 therapy sessions and I only did them so frequently because I was under the assumption it was still fully covered considering my insurance didn’t change and my provider was still in network with them. I found out today that claims for my first couple sessions came back approved but saying I owed a $10 copay for each session. It took a full 30 days for the first claims to be processed and while they were pending I was a bit concerned so my provider even tried to inquire if there was any issue with the claims they were told they couldn’t get any information until they were processed.
I called my insurance today and they basically said the full coverage for telehealth was a covid program they decided to discontinue in 2022. I asked them why my provider or I weren’t notified of the change and they said that they weren’t required to notify me and it was my responsibility to be aware of changes.
They said I could appeal but the process is annoyingly difficult. It has to be a separate letter for each individual claim that is physically mailed to them. I’m basically going to owe $100 which is fortunately not the end of the world for me but still quite an annoying unexpected expense. Is it worth me filing an appeal to get them to at least cover my last 10 sessions? Is it legal for them to switch my coverage without notifying me? Any advice on what I should do would be much appreciated.
also fyi I have Blue Cross Blue Shield in NJ
submitted by /u/thewisebrownkid
[link] [comments]I started doing telehealth therapy in Oct 2021 when my health insurance changed due to my parent switching jobs. Since then I used to do therapy twice a week bc I was told that in-network telehealth was fully covered no copay or anything. That was true up until 2022. So far this year I have had 10 therapy sessions and I only did them so frequently because I was under the assumption it was still fully covered considering my insurance didn’t change and my provider was still in network with them. I found out today that claims for my first couple sessions came back approved but saying I owed a $10 copay for each session. It took a full 30 days for the first claims to be processed and while they were pending I was a bit concerned so my provider even tried to inquire if there was any issue with the claims they were told they couldn’t get any information until they were processed. I called my insurance today and they basically said the full coverage for telehealth was a covid program they decided to discontinue in 2022. I asked them why my provider or I weren’t notified of the change and they said that they weren’t required to notify me and it was my responsibility to be aware of changes. They said I could appeal but the process is annoyingly difficult. It has to be a separate letter for each individual claim that is physically mailed to them. I’m basically going to owe $100 which is fortunately not the end of the world for me but still quite an annoying unexpected expense. Is it worth me filing an appeal to get them to at least cover my last 10 sessions? Is it legal for them to switch my coverage without notifying me? Any advice on what I should do would be much appreciated. also fyi I have Blue Cross Blue Shield in NJ submitted by /u/thewisebrownkid [link] [comments]Read Morer/HealthInsurance