>$500 Bill I didn’t expect – did someone drop the ball?

Hi, so, insurance never fails to baffle me, especially now. I’ve been in a non-stop fight with capital blue for the past year and I’m completely over them – Six months I’ve been sitting trying to get $300 reimbursed for medication. They’re ghosting me. Six months. My former UPMC coverage wasn’t great but I at least knew what on earth was going on, and could get to a human who could actually address my issues rather than shrug and say “I can’t find the things sorry” any time I try and ask questions. I hate it. So much hate. Anyway…

Before I even bother trying to ask someone anything this time and get in a canned response loop – I’m coming to reddit. You humans can be helpful.

A few weeks ago my cardiologist ordered a 14 day heart monitor. Could have anticipated it wouldn’t be free for me, but, not a single soul reached out to me to tell me I’d have any costs. I’ve always been told if I’d have more than $50 in medical expenses. “Your MRI will cost you $500, would you like to pay that today or will you need a payment plan?” – “Your insurance will only cover 25% of this testing, would you like to pay $800 today or will you need a payment plan?” – “This usually costs around $140, and we’ll let you know if insurance denies the claim.”

Being that I’m usually told by the place ordering the thing or the place that supplies the thing I’m going to assume that they’re who is responsible for that communication, but I want to be sure – because fair communication does kind of feel like something…I kind of should be paying for in the money I give my insurance company, since all they give me is nightmares and a “what if.” I don’t know. Does this fall under the No Surprises Act? Is that strictly out-of-network – it seems to be. This is in…they just decided a little less than half sounded about right, so I got a surprise >$500 bill.

See also  Balance billing for in-network care under gap exception?

I’ve gotta suck it up and pay it either way – but I kind of want to reach out to someone and say “Not cool, dude.” And see if I’m better off setting up a payment plan or using my carecredit – if the latter is even an option. Just want to make sure I do the first part with the right party.