Hey guys, I’m looking for some help over a couple of letters I received in the mail from my insurance company. Before I get into it I’d better say I’m not American, been living in California for a couple years now but still don’t fully understand how this all works, so go easy on me if I’m a bit slow.
Right, so back in January I got a coronavirus test. I’m of the understanding that insurance is supposed to cover it, at least from my understanding of the California website and what friends have told me.
I went on the state website (https://covid19.ca.gov/healthcare/) and found this:
does my health plan have to cover my covid-19 test?
Yes, if you:
Have COVID-19 symptoms,
Were exposed to someone who has COVID-19, or
The test is medically necessary for your situation.
If you have COVID-19 symptoms or think you’ve been exposed, then under federal law, you can get a test anywhere. Your health plan must pay for it.
I was exposed to someone and had symptoms, tested positive.
Last week I received a letter worded in a very strange and confusing way. At the top it states ‘This is not a bill. Do not pay’. But there is then a breakdown of payments and at the very bottom it says I owe money because ‘out of network’. Yesterday I received another letter that was similar but the amount I apparently owe was different.
Am I missing something? It says by Federal Law my insurance MUST cover me right? And I can go anywhere for a test if I have symptoms?
They just replied to me this morning and this is what they said:
As I review your claim for date of service 01/13/2021 is billed under Out of network provider MD TOX LABORATORY.
For Out of network facility we covered the COVID testing at 100% of eligible expenses as per our contracted rates , but as this claim is billed under Out of network provider our contracted rates does not applies to them and he is seeking compensation for expenses other than the COVID19 test.
Am i missing something here?
Thanks for any help guys.
submitted by /u/This-Trouble172
[link] [comments]
Hey guys, I’m looking for some help over a couple of letters I received in the mail from my insurance company. Before I get into it I’d better say I’m not American, been living in California for a couple years now but still don’t fully understand how this all works, so go easy on me if I’m a bit slow. Right, so back in January I got a coronavirus test. I’m of the understanding that insurance is supposed to cover it, at least from my understanding of the California website and what friends have told me. I went on the state website (https://covid19.ca.gov/healthcare/) and found this: does my health plan have to cover my covid-19 test? Yes, if you: Have COVID-19 symptoms, Were exposed to someone who has COVID-19, or The test is medically necessary for your situation. If you have COVID-19 symptoms or think you’ve been exposed, then under federal law, you can get a test anywhere. Your health plan must pay for it. I was exposed to someone and had symptoms, tested positive. Last week I received a letter worded in a very strange and confusing way. At the top it states ‘This is not a bill. Do not pay’. But there is then a breakdown of payments and at the very bottom it says I owe money because ‘out of network’. Yesterday I received another letter that was similar but the amount I apparently owe was different. Am I missing something? It says by Federal Law my insurance MUST cover me right? And I can go anywhere for a test if I have symptoms? They just replied to me this morning and this is what they said: As I review your claim for date of service 01/13/2021 is billed under Out of network provider MD TOX LABORATORY. For Out of network facility we covered the COVID testing at 100% of eligible expenses as per our contracted rates , but as this claim is billed under Out of network provider our contracted rates does not applies to them and he is seeking compensation for expenses other than the COVID19 test. Am i missing something here? Thanks for any help guys.
submitted by /u/This-Trouble172 [link] [comments]Read Morer/HealthInsurance