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General < General
Healthcare again
Chat0yant
World famous



Chat0yant wrote:
I'm sorry to whine again but...

MY INSURANCE COVERED NONE OF MY ANNUAL PHYSICAL LABS????????

for actual real, i knew i might have to cover a little extra because out of network but ALL OF IT??? Like i literally didn't save anything by having insurance.

so they cover annual physical but not any actual diagnosing or testing in the annual physical... AND THAT MAKES SENSE HOW?? Like if it was specialty lab maybe but it's literally what they recommend for everyone in physical??

WOW

yeah dr, sorry but i might go another 10+ years w/o getting a checkup if i'm paying $800+ to get a annual physical smh i'm so mad rn.... 

that's what i get for tryin' to be productive healthy adult, i knew it was a trap.....
20
Posts: 4150
Date: 06-10-2025 00:08
Lamby
National star



Lamby wrote:
Oh my goodness! I am so sorry to hear about that sad Not the best offer (but sadly I can't offer more) but if you have paypal I can send you like €10 if it helps anything 
10
Posts: 328
Date: 06-10-2025 00:36
Chat0yant
World famous



Chat0yant wrote:
Lamby wrote:
Oh my goodness! I am so sorry to hear about that Not the best offer (but sadly I can't offer more) but if you have paypal I can send you like €10 if it helps anything 
oh that's so sweet, i'll be ok financially, i have savings, i'm just very mad it's that high and have to finagle between cards because no cash/in person payment and.... it just shouldn't be that much, i was expecting like $200 MAX.... 
 to you
 to insurance
20
Posts: 4150
Date: 06-10-2025 00:41
Lamby
National star



Lamby wrote:
Chat0yant wrote:
Lamby wrote:
Oh my goodness! I am so sorry to hear about that Not the best offer (but sadly I can't offer more) but if you have paypal I can send you like €10 if it helps anything 
oh that's so sweet, i'll be ok financially, i have savings, i'm just very mad it's that high and have to finagle between cards because no cash/in person payment and.... it just shouldn't be that much, i was expecting like $200 MAX.... 
 to you
 to insurance
I am glad that you have the money, but I do totally agree with you. I understand not all healthcare can be covered, but it really shouldn't have been that much and it is very discouraging. Maybe next time you can somehow figure out the costs beforehand so they won't screw you over like this again
10
Posts: 328
Date: 06-10-2025 00:43
Aisaenic
Princess of Pop



Aisaenic wrote:
??? that's crazy, does your state maybe have a law against surprise bills? It might be worth disputing. I had something similar happen a while back and from that point forward anytime I have an annual I explicitly ask them whether all the labs they're running are included in the annual physical.

That one time, I was tricked into these specialty labs bc the doctor asked about my family history and said, ok so we should add these tests and I just agreed not knowing those aren't average tests...
22
Posts: 18921
Date: 06-10-2025 01:50
Chat0yant
World famous



Chat0yant wrote:
Lamby wrote:
Chat0yant wrote:
Lamby wrote:
Oh my goodness! I am so sorry to hear about that Not the best offer (but sadly I can't offer more) but if you have paypal I can send you like €10 if it helps anything 
oh that's so sweet, i'll be ok financially, i have savings, i'm just very mad it's that high and have to finagle between cards because no cash/in person payment and.... it just shouldn't be that much, i was expecting like $200 MAX.... 
 to you
 to insurance
I am glad that you have the money, but I do totally agree with you. I understand not all healthcare can be covered, but it really shouldn't have been that much and it is very discouraging. Maybe next time you can somehow figure out the costs beforehand so they won't screw you over like this again
yes, i def will check harder next time before assuming. I won't have this insurance for long though so it will be a bit before it comes up again...
20
Posts: 4150
Date: 06-10-2025 04:03
Chat0yant
World famous



Chat0yant wrote:
Aisaenic wrote:
??? that's crazy, does your state maybe have a law against surprise bills? It might be worth disputing. I had something similar happen a while back and from that point forward anytime I have an annual I explicitly ask them whether all the labs they're running are included in the annual physical.

That one time, I was tricked into these specialty labs bc the doctor asked about my family history and said, ok so we should add these tests and I just agreed not knowing those aren't average tests...
i went and read about my bills, the explanation of benefits, etc. and i don't really think i can argue it? From what i can tell, it's my fault for not understanding my benefits and how out of network costs work. No one explicitly told me i would or wouldn't pay for the lab and im pretty sure they are routine labs so like... it's just my fault right? surprise to me doesn't = surprise billing... Like i'm mad it's so much but I should have researched more instead of assuming they would be included or partially covered...

also they apparently accepted a miniscule amount into deductible so it's only "partially denied" (like <10%), so i feel like i can argue it even less because they did "accept some of the costs" (i just still have to pay it out of pocket...)

insurance is really confusing idk even how to tell what's what... like i could call customer support but wouldn't they just say the same thing, it's out of network so not covered? 
20
Posts: 4150
Date: 06-10-2025 04:17
Aisaenic
Princess of Pop



Aisaenic wrote:
Chat0yant wrote:
Aisaenic wrote:
??? that's crazy, does your state maybe have a law against surprise bills? It might be worth disputing. I had something similar happen a while back and from that point forward anytime I have an annual I explicitly ask them whether all the labs they're running are included in the annual physical.

That one time, I was tricked into these specialty labs bc the doctor asked about my family history and said, ok so we should add these tests and I just agreed not knowing those aren't average tests...
i went and read about my bills, the explanation of benefits, etc. and i don't really think i can argue it? From what i can tell, it's my fault for not understanding my benefits and how out of network costs work. No one explicitly told me i would or wouldn't pay for the lab and im pretty sure they are routine labs so like... it's just my fault right? surprise to me doesn't = surprise billing... Like i'm mad it's so much but I should have researched more instead of assuming they would be included or partially covered...

also they apparently accepted a miniscule amount into deductible so it's only "partially denied" (like <10%), so i feel like i can argue it even less because they did "accept some of the costs" (i just still have to pay it out of pocket...)

insurance is really confusing idk even how to tell what's what... like i could call customer support but wouldn't they just say the same thing, it's out of network so not covered? 
 omg wait i didn't realize this involves out of network care
You have the itemized bill right? I'm also assuming you're in the US? If so, check out the 2022 No Surprises Act, I feel like you can sufficiently try arguing using it
www.cms.gov/nosurprises <- i would try this first, the website has instructions 
22
Posts: 18921
Date: 06-10-2025 04:27 | Times changed: 2
Chat0yant
World famous



Chat0yant wrote:
Aisaenic wrote:
Chat0yant wrote:
Aisaenic wrote:
??? that's crazy, does your state maybe have a law against surprise bills? It might be worth disputing. I had something similar happen a while back and from that point forward anytime I have an annual I explicitly ask them whether all the labs they're running are included in the annual physical.

That one time, I was tricked into these specialty labs bc the doctor asked about my family history and said, ok so we should add these tests and I just agreed not knowing those aren't average tests...
i went and read about my bills, the explanation of benefits, etc. and i don't really think i can argue it? From what i can tell, it's my fault for not understanding my benefits and how out of network costs work. No one explicitly told me i would or wouldn't pay for the lab and im pretty sure they are routine labs so like... it's just my fault right? surprise to me doesn't = surprise billing... Like i'm mad it's so much but I should have researched more instead of assuming they would be included or partially covered...

also they apparently accepted a miniscule amount into deductible so it's only "partially denied" (like <10%), so i feel like i can argue it even less because they did "accept some of the costs" (i just still have to pay it out of pocket...)

insurance is really confusing idk even how to tell what's what... like i could call customer support but wouldn't they just say the same thing, it's out of network so not covered? 
 omg wait i didn't realize this involves out of network care
You have the itemized bill right? I'm also assuming you're in the US? If so, check out the 2022 No Surprises Act, I feel like you can sufficiently try arguing using it
www.cms.gov/nosurprises <- i would try this first, the website has instructions 
it's a lot of reading but from the pages i've read, i don't qualify because:

the facility (not just the dr/lab/test) was out of network [Main Reason]
            (my plan is employer based thus SUPER specific, so it had to be sadly...)
I did not ask for a good faith estimate
i tried to use insurance (not out of pocket or uninsured)
20
Posts: 4150
Date: 06-10-2025 04:45 | Times changed: 2
Aisaenic
Princess of Pop



Aisaenic wrote:
Chat0yant wrote:
Aisaenic wrote:
Chat0yant wrote:
i went and read about my bills, the explanation of benefits, etc. and i don't really think i can argue it? From what i can tell, it's my fault for not understanding my benefits and how out of network costs work. No one explicitly told me i would or wouldn't pay for the lab and im pretty sure they are routine labs so like... it's just my fault right? surprise to me doesn't = surprise billing... Like i'm mad it's so much but I should have researched more instead of assuming they would be included or partially covered...

also they apparently accepted a miniscule amount into deductible so it's only "partially denied" (like <10%), so i feel like i can argue it even less because they did "accept some of the costs" (i just still have to pay it out of pocket...)

insurance is really confusing idk even how to tell what's what... like i could call customer support but wouldn't they just say the same thing, it's out of network so not covered? 
 omg wait i didn't realize this involves out of network care
You have the itemized bill right? I'm also assuming you're in the US? If so, check out the 2022 No Surprises Act, I feel like you can sufficiently try arguing using it
www.cms.gov/nosurprises <- i would try this first, the website has instructions 
it's a lot of reading but from the pages i've read, i don't qualify because:

the facility (not just the dr/lab/test) was out of network [Main Reason]
            (my plan is employer based thus SUPER specific, so it had to be sadly...)
I did not ask for a good faith estimate
i tried to use insurance (not out of pocket or uninsured)
oof gotcha  
22
Posts: 18921
Date: 06-10-2025 05:34
Chat0yant
World famous



Chat0yant wrote:
Aisaenic wrote:
Chat0yant wrote:
Aisaenic wrote:
 omg wait i didn't realize this involves out of network care
You have the itemized bill right? I'm also assuming you're in the US? If so, check out the 2022 No Surprises Act, I feel like you can sufficiently try arguing using it
www.cms.gov/nosurprises <- i would try this first, the website has instructions 
it's a lot of reading but from the pages i've read, i don't qualify because:

the facility (not just the dr/lab/test) was out of network [Main Reason]
            (my plan is employer based thus SUPER specific, so it had to be sadly...)
I did not ask for a good faith estimate
i tried to use insurance (not out of pocket or uninsured)
oof gotcha  
i appreciate the info and your help, though! I wouldn't have known how/where to look to find that answer for sure
20
Posts: 4150
Date: 06-10-2025 05:49
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