I am 28 years old and have been morbidly obese since childhood. After moving out to college I started to build a healthier relationship with food and exercise but it has been hard. There have been many lapses, many regressions. I'm trying as hard as I can to lose weight on my own through diet (calorie restriction, Mediterranean diet) and exercise (mostly biking). I'm actually down about 30 pounds from the beginning of the year but I'm starting to plateau at about 315lbs. At this point my doctor and I both agree that additional help is needed.

Medically, I have non-alcoholic fatty liver disease which has progressed to Metabolic Dysfunction-Associated Steatohepatitis (MASH). I had a fibroscan at a facility in March which indicated severe scarring of the liver. In addition to this I also have high blood pressure caused by being morbidly obese. In mid June my doctor prescribed me Wegovy, which requires prior authorization with my insurance (United Healthcare). My plan unfortunately does not cover weight loss meds for the purposes of weight loss alone, but we were hoping that with the additional context of the MASH diagnosis and high blood pressure they would see that this is medically necessary to prevent further heart/liver damage.

I actually gave United Healthcare a call yesterday to ask about the status since it's been a month and I haven't heard anything and the advocate told me it was approved! Yippee! Except actually, when I checked the myUHC app later that evening it said denied. This led to an hour long phone call with them where they spent most of it with me on hold, waiting for them to tell me what I already knew, it's denied because it's a plan exclusion. I took the night to cool off then earlier this morning I called United Healthcare again to discuss this with an advocate and they told me what OptumRx (their Rx approval team?) was looking for. They want to see my fibrosis stage and my liver stiffness measurement, both of which were already in the original prior authorization. Did they just straight up not read the original prior authorization and stamp it as denied? I understand it's a plan exclusion but I should not have to appeal this to get this health insurance company to do their job correctly. Like, are they just hoping I won't appeal? What is going on here? Has anyone else experienced this? How can they deny me and then ask for additional details they have already been given?

My husband's company was recently sold to another company. They offered new insurance plans and had him select the plans. We waited for new insurance cards and mail to arrive and nothing. I have parental appointments, my kids have therapy and check ups so I continued with those appointments this month.

I asked my husband to ask HR regarding our insurance. They told him that the new company was still processing the changes and that we should cancel our appointments until wet get our new cards. Some employees had already gotten their insurance but not all. I had already gone to a few appointments so was upset. We were informed that the old insurance ended on 6/30/2026. We ended up getting a bill for my son's OT for close to $800 and cancelled our future appointments since they said insurance confirmed coverage ended. We are upset because we were left with no coverage for that time and I had already a prenatal and a check up for my other son. Those bills are probably coming any time soon.

I checked the mail today and the cards finally arrived. Can we ask the company to pay for our bills during the gap since it doesn't seem fair they did not do a great job of managing the transition and some employees did get their benefits before us? Or are we still responsible for those bills? What should we do?

My family and I recently got new insurance and with it got vision insurance. We got it started on February 1st. My vision is extremely bad and only now am I needed a new prescription after a couple years, so tried to make an appointment but the office said that while they accept my insurance, they can’t find a vision card in my name, as in staring at the card in my hand. I sent them info and a picture and they still weren’t able to take it. So I checked my plan on the website and it says it was only active from 02/01 to 05/01. Why did I only have it active for 3 months? I understand that there is a limit of 1 exam per year which makes sense, but 2 months ago I could see fine and now my vision is slowly but surely getting worse even with my glasses. I don’t get it. I’m new to all this adulting shit, so please help me out 😔

I’m interested in switching mri imaging center due to cost and location. I went in for my appointment today but mri was down and it was rescheduled for four weeks later. The location ended up being a little further out than I expected. I think because I’m getting the mri done at an actual hospital is what’s making it so expensive. I was able to look up some standalone image centers and I found out it could have been a few hundred dollars less.

Who would I have to call to change imaging center? Primary care doctor, my insurance, or the imaging center? Could an authorization be updated for a new location or would I have to get a completely new authorization?

I did pay the mri bill before the appointment because I was required to. I’m assuming that as long as I never received the mri I should get a full refund.

Location is California and I have BCBS

If anyone here was able to change imaging centers, what steps did you take to do that?

Specifically if you are type 2 and it helped get your A1C down for a few years but you had a bad year and A1C went back up? Can’t take Metformin with it because I had too many bathroom emergencies.

We have a Molina Gold plan and it is very expensive but we needed a low deductible for the birth of our child. When I add the newborn to our plan, it allows us to "Change" plan. My first thought is going into a bronze plan with a high deductible to save money since I don't need it for childbirth but it shows the effective date for they policy is the baby's date of birth. Does that mean the childbirth will now bill the new insurance with a high deducible and I just screwed myself?

Hi all,

I’m planning to freeze my eggs and recently realized that my regular health insurance does not cover medical complications arising from fertility treatment or oocyte retrieval. I am living in the USA.

I’m not asking about coverage for the egg freezing cycle itself. I’m specifically worried about complications that could require medical care, like OHSS, bleeding/hemorrhage, infection, ovarian torsion, anesthesia complications, ER visits, hospitalization, or surgery.

Has anyone else been in this situation where their normal health insurance excluded fertility-treatment complications? If so:

1. Did you purchase separate complications insurance?
2. What company or policy did you use?
3. Did anyone have experience filing a claim?

Any experiences, policy names, or questions you wish you had asked before buying would be really helpful. Thank you!

Hi, today I got a bill from quest diagnostics stating that I owed $1400 for bloodwork I got done in May. At the appointment then, I presented my insurance card and it seemed to process fine, so I got it done.

quest said my insurance, curative (under cigna network) denied it, but after calling curative they said the claim never reached them and advised me to call quest to have them resubmit the claim. I did that and the agent told me it will be another 4-6 weeks til I know how much my insurance will actually cover; it should be everything, but now I’m nervous lol.

interestingly, I noticed on my bill that my insurance ID number had a random extra two numbers at the end of it (not after a dash or anything like that) so I’m thinking part of the issue might’ve been the phlebotomist entered it wrong.. but in that case how did it go through at all in the beginning when I got the bloodwork?

has anyone dealt with this before? though I’ve dealt with it for now I’m very concerned there’s going to be more bullshit at the end of this 4-6 weeks to deal with.

I have a somewhat complex insurance situation that I’m wondering if anyone has dealt with before.

I am looking to get a procedure done that would require a prior authorization in order to be covered.

My primary insurance policy does not include the procedure under its covered benefits (I have confirmed this with a rep). My secondary insurance policy does include this as a covered benefit as long as I get a prior authorization approved before the procedure.

I called my secondary insurance asking what the best course of action would be for this situation and their representative said that if the procedure is not covered under my primary insurance’s plan they will cover the procedure as long as I get a prior authorization approved by them before the procedure AND they get a denied claim/EOB from my primary insurance once the procedure has been completed.

I have called my secondary insurance a couple times to confirm this is the correct order of operations, but I have been given incorrect information from insurance reps before and I’m nervous I’ll end up having to pay out of pocket after the procedure or something because I went through the process incorrectly. So I’m wondering if anyone’s ever run into a similar issue and if so, how did everything play out?

My employer had open enrollment this past June (effective for this July) and attached a benefit guide for the 2026-2027 year. I was on the copay plan due to mental health having no charge, and saw that stayed the same on this benefit guide except for the plan costing an extra $13 each paycheck. Since I see a therapist routinely, I was okay with this since the benefit guide stated mental health is remaining no charge.

Today, I get notified from my therapist provider that a cost correction will be charged to me for my sessions in July. My insurance informed them my copay is actually $85, which is when I checked my employers website and saw the benefits guide is different and now shows mental health at a $85 copay.

At this point, I have two benefit guides dated for the same year showing two different copays. I also have the email from when HR sent the first benefit guide for open enrollment showing no charge. Is there anything I can do about this to hold my employer accountable? I only paid for this insurance due to the mental health coverage and if I knew it would be $85 I would have taken the lower cost plan.

Hi I’m a US citizen who needs gap insurance before leaving the country in September. I don’t have an income. I just was to buy it out right.

live in illinois no current income just living with my parents lost my insurance from being let go got a good severance but gonna loose my current insurance which i really like but i don’t know if medicaid is better or going thru cobra or going aca route anybody have advice ? thank you in advance

I’m starting Medicare this year at age 65. Looking to see if folks in Cali can advise on plan G high deductible insurance company they went with for best price and lowest rate increases.

I received a letter in the mail and am confused by it. I tried searching and found on a Kaiser sub about it not being a scam. The reason the letter is confusing is it talks about me suing someone and providing my insurance company money from any settlement I get.

I’m not suing anyone. Yes I was in a car accident. The person didn’t have insurance so there’s nothing to do. I was thankfully not injured and only had an initial exam same day as accident. If I call the person on the letter and say I’m not suing anyone, there’s nothing to sue, that is all that’s potentially needed? I’m not winning any settlement (because I’m not suing anyone) and my car insurance didn’t pay for medical expenses, only car expenses.

Hello,

I was looking for some advice or help with CVS minute clinic. I went to one last year for some blood work and tests and I was told that my insurance would cover and I paid my copay and all was good.

A lot of time passed and I get billed for it and I’ve reached out to insurance and the CVS location to possibly get it under insurance. It was under tricare and I’m being charged $400 now. The claim keeps coming up as under a different providers name and not as minute clinic or the provider I saw.

I’ll take any advice or help I really just cannot afford a $400 bill and I have not had issues prior to this. Thank you in advance!

Hullo! I have health insurance through my current employer but I am leaving this job at the end of the week. My coverage extends for up to a month after my departure. I have a new job that I will be starting in two weeks and will get new insurance through them. So there will be a period of time that I will technically have two health insurance policies.

I’m also expecting and have an appointment planned with my current provider (the week I start my new job), which won’t be in network with my future health insurance. Are there any issues with going to my current provider or should I cancel that appointment and just schedule something with a provider who will be in-network with my new employer health insurance?

So I (newly 26) can no longer be on my parent’s tricare plan, and in recent months went through the application process for my state’s fssa benefits for the state healthcare plan. There’s a lot I could say for how confusing it all was, but putting it aside, I checked today and it said I was denied for lack of proof of residency and of previous insurance coverage.

I submitted my learner’s permit and it should’ve been fine as far as I know? For the previous insurance, that might make more sense- I submitted photos of my father’s military ID since that’s what we’ve always used as proof of insurance and medical places etc before since it has his numbers on there, and I don’t have any other actual documents about it or my own account, just a dependent offer through him.

So my options now are appeal (court???) or look for another insurance. In the past two years or so I’ve come down with an illness that has been treatment resistant so far (a severe ibs case, and possible endometriosis the docs think) and I can’t work right now until we find medication that helps, so that’s out. I also have a lot of doctor visits and medications because of that. Should I go to marketplace or appeal? Going to court is also an issue because of my illness and complete lack of knowledge on court shit. Please advise.

Reddit keeps suggesting I post this here. I hope it and the original post are helpful for the community.

All the best!

I’m an international student starting at UMD this fall as a junior. UMD is charging me about $3,000 for the Student Health Insurance Plan (SHIP), but I saw that it’s possible to waive it if you have your own insurance that meets their requirements. They mention that the plan must be ACA-compliant.
As an out-of-state international student, tuition is already incredibly expensive, so I’m trying to reduce my costs wherever I can.
Has anyone here successfully waived SHIP? If so:
● What insurance did you use?
● How much did it cost?
● Was the waiver process straightforward?
I’d really appreciate any recommendations or advice. Thank you!

My wife is covered by my employee health insurance (primary insurance) and Medicare (secondary). She has had a spinal cord stimulator for years and it needed replacing due to the battery dying. The procedure to replace was pre-approved by our insurance. There was a snowstorm the day of the procedure and it was rescheduled to a different day by the doctor at a different facility. She has more than one practice in the area and this new one is where they could fit my wife in.

It appears our insurance is claiming the new facility is now out-of-network, according to the explanation of benefits. And is not paying for most of this.

It's worth noting that there are 3 EOBs:

1. Anesthesia for the procedure - covered (owe $84.00 on EOB)

2. Doctor performing the procedure - covered (owe $690 on EOB)

3. The facility where the procedure was performed - out of network; plan paid $40k; owe $142k on EOB)

Not sure what Medicare is going to pay for at this point.

This kind of thing has happened before, where a procedure we received pre-authorization was charged out-of-network. Two years ago in fact, my insurance and the doctor were going back and forth about a different procedure. It only in the past 6 months shows the EOB and being completed and not still in-process. Worth nothing the EOB says we'd owe $39K but we never received any kind of bill for it. Medicare is showing the claim as well. According to that, we owe $0.00. I'm hoping that's the case for this new charge.

I guess I'm looking for advice on how to go about appealing.

The older procedure went away, we're assuming due to how Medicare pays out. Will that happen again? For the amount that we supposedly owe, I don't want to wait for all that paperwork to go through and be too late to file appeals. We are contacting the doctor to see what they are doing to appeal as well.

Thanks in advance. I'm the type of person who stresses about the unknown and looking to relieve some of that anxiety as well.

My wife and I recently lost our health insurance through our employer so I went on the Marketplace to checkout our options. The lowest plan we were offered is $550/month, doesn't include dental, and has a $20k deductible. Lol. What a joke USA.

I went on BCBS website to see what individual plan would cost and already seeing better options. I chose "Marketplace options" through the insurance website, so I guess it's still from the "marketplace", but these options weren't available directly on the marketplace website.

Does anyone ahve any insight - and have you purchased directly from the private insurance website as opposed the the government one?

Hi! By my current calculations, I currently am eligible to enroll in the NYS Essential Plan.

I was curious as to what happens my calculations were not correct/if I end up making more money than the income limit by the end of the year after I am already enrolled and started utilizing the plan?

Is this a parks & rec “jail” scenario? Or am I going to be ok?

Thank you!