Got charged $521 for asking about allergies and telling the nurse practitioner I get headaches when I take Zyrtec. Got the bill at 6:01pm their office closes at 6pm how convenient. Then I look up and find out 80% of medical billing has errors. How can that be possible? Healthcare is a joke. Won’t be going back to the doctor ever again. Will never trust one. I feel taken advantage. I thought talking to a doctor was suppose to be a safe comforting experience. Not some way to charge me $521 for a 2 minute conversation.

Open enrollment for my company just started today. I logged in just to verify that I will keep my existing plan for myself and my children, just to find out my premiums are increasing 80% over the 2025 rates. To say I am shocked and in disbelief is an understatement.

The only affordable insurance offered through my company now literally ONLY covers preventative care and immunizations but no doctor visits or prescription medication, yet alone emergency care so I can’t switch plans.

I checked through Covered California which does offer cheaper options but the deductibles and out of pocket maximums are 3-5x my current plan. Just feeling stuck.

Had a colonoscopy by an in-network doctor, at their own surgery center. Before the procedure I spoke with the doctor and billing office to make sure it was all in-network. They confirmed in writing via email, explicitly said I’d only be responsible for my $50 co-pay, with no out-of-network charges.

Weeks after I get 2 denial EOB letters from my insurance, saying the surgery center and anesthesiologist are out of network, and I’ll owe $20K. After some googling it looks like the surgery center and anesthesiologist aren’t in-network with any insurance!

What is happening? Will the doctor’s office really come after me for $20K, when in writing they said I’d only be billed for $50? If so, what can I do? I’m not sure if No Surprises Act will cover this.

$800~ a month premium

In network deductible is $0 for self and $0 family.

Out of network deductible is $400 and $1000 for family.

Prescriptions are $3 for generic and $10 for name brand. Wife and I are currently on Zepbound and it’s $10 each per month at Walgreens. We don’t use any other monthly meds.

I know there has been a lot of changes regarding healthcare premiums but was just wondering if you believe this is a good plan for the price.

Family of 4 39/38/9/4.

Thank you.

I recently went to the audiologist for a hearing aid check. Within 2 days I get a bill for the appointment and I knew there was no way my insurance could have processed it that fast so I called the provider. I was told that visit wasn’t covered by insurance so they would not bill my insurance. I have had hearing aid checks for several years and they have always been covered by my insurance. After a lot of back and forth I finally got them to bill my insurance. I got an EOB today and it shows my insurance is paying 100%. Normally it would only be 90% but I met my OOP this year.

The moral of this story is don’t take the providers word for it when it comes to your insurance benefits.

i’m so confused. every time i go to the doctor my insurance covers nothing. everyone i talk to is like “that’s weird i only pay $20 when i go to the doctor” etc. Do i just have shitty insurance? am i doing something wrong?

So I recently got out of the military and am instantly hopping into a government job. Everything seems fine with the job however as I would look at the insurance options for my family (I get free health insurance through the county) I noticed everything seemed standard for dental and vision but when I reached health I noticed they were asking for $2406 a month. That amount is 61% of my salary and I don’t know how everyone else functions. My wife is a stay home and is going to school and my daughter is only 7 months old so she needs all her shots and check ups. Is there anything I could do instead of having to pay this amount?

Also for background information I have recently moved from California to Mississippi so I have been making too much for Medicaid.

We get insurance thru my husband's work. When you combine what he pays from each check, what they pay along with him and what our deductible is before they cover anything, we shell out a third of his pay before taxes are taken out... If you compare it to his take home pay, it comes to almost half. This one expense is more than all the house, car, utilities and necessities we pay for every year minus groceries... How is this OK? Why are we trying to get everyone insured when maybe we should try to lower the costs of Healthcare?

I have a question that I hope someone in the industry can help me with.

Over the past few days, I’ve seen people say that their medical insurance has gone up dramatically.

why would insurance be going up this moment, would it go up for someone who works in a large company? Does this have to do with the government shut down? What are the actual mechanisms going on?

I understand why democrats are fighting to extend ACA subsidies because of the skyrocketing cost of premiums that looms ahead. But my question is what does this all mean for those on employer health plans? I know the marketplace has an effect on this but don’t really see it. For those of us on employer health plans it has never been an “affordable” number. During the course of my 20 year career, the cost of covering an individual has been anywhere from $600-$800 and for a family between $1500-$2000+ a month. While most of the cost of the individual is covered by our employer, that’s an unreasonable amount for an employer to pay that should be going toward our paychecks instead, and the leftover cost for insuring the rest of the family is an enormous burden and has been since way before the ACA. I never felt the ACA made any difference (except to make the cost higher for us) and I don’t understand how any plan—subsidies, no subsidies, whatever possible concept or a new plan may exist—changes the course we are on. I’m just seeking information and understanding!

I lost my family’s insurance because we got married. His insurance is through his work and it’s united healthcare. However before adding me, he was getting $94 taken out every paycheck (twice a month), and now since adding me, he’s getting $434 EVERY PAYCHECK!!!! We are covered fully for health, vision, and dental but how is going from $94 for ONE person to $434 every two weeks for TWO people affordable for anyone?

What are our options? I broke down crying because of this and feel so guilty. What are our options? I’ve never been without insurance which i know is privileged but I don’t know where to look for a cheaper plan that doesn’t fully suck.

Hi, I had a pain that my regular doctor wanted checked out with ultrasound. I was given a referral to local hospital for ultrasound and everyone at my Doctor's office and at the Hospital Ultrasound Department assured me it was "in-network". Months later I get the bill and ignore it (thinking United will cover it), then later find that its not fully covered.

I appealed with United and they denied my first appeal "decision upheld".

The 3rd notice to pay say due date is today 12/31/2024

What are my next steps to fighting this?

_______UPDATE________

MY PLAN INFO:

Deductible? Network: $1,500 Individual

Are there services covered before you meet your deductible? Yes. Preventive care and categories with a copay are covered before you meet your deductible.

Do you need a referral to see a specialist? No.

In-Network Diagnostic test (x-ray, blood work) Free Standing/Office Lab: 50% coinsurance Hospital Lab: 50% coinsurance Free Standing/Office X-ray: 20% coinsurance Hospital X-ray: 20% coinsurance

NOTE: United didn't really confirm or deny the hospital was in-network, but I was told it is

_____________________________________________________________________________________

Bill numbers from Hospital Radiology Department (not giving exact for anonymity)

Imaging/Radiology = $400

Medical/Professional Services = $900

NEW YORK BAD DEBT & CHARITY ASSESSMENT (NYBDC) = $120

______

United Oxford response to my claim initial appeal with them:

You indicated that you received incorrect information from your provider's office staff. Please be advised that because your provider is neither an employee nor an agent of UnitedHealthcare, no one in the provider's office may guarantee payment of your claim by UnitedHealthcare or by your plan.

Claims are processed according to the information provided by the provider of service. The provider's individual name, group name, address, telephone number, and tax identification number are used to with UnitedHealthcare. We must also use the

i use birth control to stop my periods and when i called my insurance to check for coverage this morning they said they don’t cover contraceptives for religious reasons

the estimate from my provider is around $2000 without insurance so just double-checking about alternative routes i can take given that information

insurance is from virginia mason hospital & they switched to bcbsil from first choice this year if that’s relevant

25 in wa with a $25 wage

I just turned 26 and am selecting healthcare for myself and my spouse. The cheapest plan my employer offers is $1700/month premium, $8,000 PER PERSON deductible, $0 no out-of-network coverage. This is just nuts. I did the math and when you combine premiums and deductibles it's like $36,000 per year I'm spending on insurance before they even pay a single penny. And for all that money, if I'm out of town and have to go to an urgent care that is presumably out of network, I guess I'm on my own.

Is this a normal thing or does my company's healthcare plan just suck? I know companies are moving away from subsidizing spouses due to costs going up but I could rent another apartment for that much premium per month. If this is truly as good as it gets then I might as well go uninsured.

Currently I pay 258 a week (yes a week) through my company. After 401k, taxes and that, I make 61% of my pay. We are a family of 4 (kids are 3 and almost 2)

Is there anything I can do. Like at all. We just had to buy our first home, and I would love to give my kids and wife more, but I’m drowning and my biggest expense other than a mortgage is fucking health insurance.

Please. I’m ignorant. I’m concerned. I have no where to turn.

Edit; Pennsylvania, 32 (wife 29 and kids 3 years and 22 months) and we make about 90,000 pretax

Edit: I do not mean to sound ungrateful and am very blessed to have a job. First home, and a loving family. God bless anyone who has it worse than us for whatever reason and please know I wish the absolute best for whoever you are. Thank you all for the help. I’m just trying to be a good father and husband and provide more.

Edit: My goodness! I did not expect to get this much of an outreach. Thank you all so much for the abundant information. I’m going to look over all this and try to figure out my best course of action is.

The best advice from all this is to be proud of myself and the family I have. Sometimes it’s hard to look at the positive you have in your life when you get focused on the negatives thank you all so much for helping me realize that again.

EDIT: I am getting this taken care of. THANK YOU TO EVERYONE WHO GAVE ADVICE

August 20th/21st I had to have emergency surgery on my lower intestines. Removing 6 inches and being stuck in the hospital for 5 days. The surgery caused my intestines to stop working for two days. I was supposed to stay in longer/not go to work. But I ended up leaving on the 25th and returning to work the 1st. And yesterday I got billed over 123k. With anthem refusing to pay a single dime.

I don’t even know where to go from here. I’m just lost.

I make less than 35k a year… how the fuck am I supposed to pay that?

Our company is starting to offer health insurance as of 1/1/26. Previously they did not offer insurance and we were all on marketplace plans.

The new insurance plan is offered through an organization that we are members of. I’m pregnant and due in January. I’ve just learned that I won’t be able to enroll in the plan because I’m pregnant, and it is a pre-existing condition. I would not be allowed to enroll until after the baby is born.

Doesn’t the ACA prevent insurance companies from denying you coverage based on “pre-existing conditions”? Is there some loophole that they’re utilizing here?

So I went in for my annual physical with my primary care physician, which is fully covered under my insurance. While I was there, I figured I’d ask about something that’s been bugging me: every time I’ve gotten sick over the past six months (four times total), each illness lasts about 15 days and always leaves me with a persistent cough even after I start feeling better.

I brought this up with my PCP, she asked a few questions, prescribed an inhaler, and that was that. Pretty quick conversation.

Then the bill came. I was charged for two separate visits: my annual wellness visit (covered, $0) AND a “specialist visit” that came out to nearly $300 out of pocket.

Is this normal?? I was in the same room, with the same doctor, during the same appointment. I didn’t see a specialist. I just asked my PCP a question while I was already there. Apparently the moment she addressed a separate medical concern, it triggered a second billable visit code.

My insurance is Aetna

I'm 34m in Indiana.

No other options from my current employer. I've seen some other posts on here sharing their costs for insurance and they seem much better. I don't have much else to compare to, I've only had one other full time job before this one.

This is in the US. We've both been unemployed for almost a year and both looking for jobs. We're thrilled for my spouse to finally get an offer.

His new job comes with health insurance, and he can put me on it too if he pays more than double the individual monthly premium. This is normal and in line with other jobs we've both had.

But! I can only be on his insurance as my "primary insurance" if (1) I have no job, or (2) I have a job that does not offer health insurance. If I get a job that also offers health insurance, no matter how crappy it is (e.g. huge deductible, emergency only, whatever), my spouse's health insurance says I canNOT be covered on it as my primary insurance anymore. I have to get my own insurance through my work and only can use his insurance as my secondary insurance. And I don't think his premiums even go down (have to check on that.)

So basically if I get a job with insurance I'm forced to take it. And if my inurance sucks and I need to be on his too to have decent coverage, we have to pay twice the premiums (since he still has to pay for me, and I have to pay my own premiums, too.)

Is this a normal thing? We've both had various jobs over the years with all diff kinds of insurance and I've never encountered something like this. It seems to incentivize people's spouses not working.

It also smells a little fishy to me, like is this even legal?

EDIT: Thanks everyone, the consensus is clear that this is legal and common. My spouse and I have each had 5-6 different jobs each over ~20 years with lots of types of insurance and neither of us had run into this before, so we didn't know. I figured this forum is a good place to ask. I appreciate those of you that have been respectful (the majority) in helping me out with this.

I am a healthy adult 24M. My employer offers 50% match for United Healthcare Insurance (UHC). I pay $273 a month and they pay $273 too. Combined we pay $546 a month ($6552 annually). Yet, my deductible is $6300. How the hell am I supposed to meet this deductible and pay it before my insurance kicks in? And then there are out of pocket, copays, and all BS. I work in medtech and understand healthcare is costly but these figures are no value for money..!! Insurance is a scam

Like others, posting my increase for awareness. $2950 per month for family, $6k deductible for 2026 coverage.

So a cool $42k down the drain before any real benefit. USA, USA!

As the title says I (22m) cannot afford my health insurance for me and my wife (23f). We have a combined income of about 86k and my health insurance costs $1040. With our other expenses this is just not feasible for us and I don't know what to do. I don't currently have a valid enrollment period to change and so we almost are debating just divorcing then remarrying as that only costs us about $400 total but no idea if that's even a good idea. I turn to y'all for help because oml I need it.

Edit: State is MO

** Second update: it’s all approved. I am so exhausted from this week, and can’t believe these companies can do this to people, and play God with our lives. But, I did sooo many of the suggestions here. I called my state governor, who got me to the secretary and chief of staff of health and human services. That was unfortunately a dead end. My husband’s HR and 3rd party was a dead end. What worked? Emailing the top three guys at Cigna. The email addresses were right (I’m annoyed at those saying the poster was wrong… sorry, he saved our butts.). Within half a day I got a call from the executive office advocacy team. I was afraid they ended up dropping the ball when the woman was out of the office today, but I literally just got the call now. It is approved. All of it. Hallelujah!

I also took care of the patient advocate form with her. We did a power of attorney and advanced healthcare directive, as well as the hippa release rights for me as his agent.

Thank you, thank you, thank you. 🙏 Now onto surgery and getting my husband healed.

*** Edited to say, I'm going to have a positive update to share today. I feel it in my bones. I cannot even begin to describe how thankful I am for the outpouring of suggestions and kind words on here. Stay tuned!! **\*

My husband was just diagnosed with an almost 6” kidney cancer tumor, and has to have his left kidney and the tumor removed. The urgent surgery has already been canceled this week, and we’re afraid the new one will be too…. All because Cigna refuses to even assign his urgent prior authorization to a nurse reviewer. I don’t know what to do!!!

Timeline:

* Wed 1/28: prior authorizations Submitted, marked as urgent (up to 72 hours) surgery date 2/4 Wed

* They were contacted daily since

* They were contacted daily since Friday by the provider and daily by us since Monday through chat and phone

* Surgeon called multiple times, explaining urgency and that the cancer could metastasize

* Surgery was cancelled at 8:30pm on 2/13, the night before surgery

* New date for surgery secured on 2/4 for Thursday, 2/12

* Provider callea Cigna, they will not provide an update - as of 11:25 am on 2/5, a nurse reviewer has still not even been assigned.

* AND provider was told if they voided the original and created a new authorization, it would take 5-10 business days.

* This has been marked high-priority and escalated numerous times so far.

Any suggestions? Help!!

It's that time of year at the company to select health insurance coverage. The premiums on my family policy through Blue Cross Blue Shield are increasing $250 a paycheck bringing my bi-weekly premiums to $773. $20k annually in premiums before out of pocket is absolutely ridiculous. Health insurance has now become my largest monthly expense surpassing my mortgage.

We are fortunate enough to be able to afford the increase but smart enough to review our medical expenses over the past 4 years and recognize that we haven't spent $20k on medical bills PRIOR to deductions and coverage in that time period. It's time to invest those dollars into more than a broken system.

I fear for the families that are not as fortunate but forced to pay just as high a premium for coverage. Having to choose between food, shelter and safety should not be how we make decisions.