Insurance Audit Reversed Deductible Contributions
Hoping someone can help me. I have insurance through the marketplace, a high deductible plan that kicks in 100% once deductible is met. I am on a very expensive medication and the manufacturer helps pay my out of pocket costs until I hit my deductible, which I did in March of this year. I have had all my medical and prescriptions covered 100% per the plan up until July 24, when apparently, an audit was run by insurance.
They have removed the contributions from the drug manufacturer. As I was researching my policy, I was literally watching my deductible remaining go up and up as I refreshed the page.
Looking at the contract, it looks like they absolutely can do this – but I had no issues Apr-July and no issues all of 2023 with this contributing to my deductible and having them pay 100%.
Do I have any recourse or actions I can take to defend myself here? I have an upcoming surgery that I wasn't expecting to pay for and now will be liable for $3k. Sorry for any formatting issues, I almost never post here.
submitted by /u/trunksiex
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