Appeal Decision- Bright Health

I recently moved back to the US after years abroad (with sweet, sweet public healthcare). I am 29F living in Georgia with Bright Healthcare.

I am unemployed and looking for a job, but was able to sign up for insurance through the marketplace (Silver plan).

I wanted to get an IUD inserted and saw that they were covered on Bright’s website. I set up an appointment with my dr and got it inserted.

My claim has been rejected because it is covered as a pharmacy benefit, not medical. (Which makes no sense to me, as I cannot insert this on my own) And the insertion fee is not being covered because I needed to get prior approval (aka paying for 2 appointments instead of one)

My doctor’s office told me it would be $0, but I now realize they never ran it by my insurance and that was just my cost that day for the office. I haven’t had to deal with the madness of US insurance basically ever and didn’t know I needed to double-check that.

I now have a $2,500 bill that I cannot pay. Nor do I want to- this should have been fully covered.

It would have been cheaper (max $1,000) to pay direct to my doctor. I’d rather they have the money than the insurance company.

What can I do? I am so stressed constantly with this bill hanging over my head. Can I change from using my insurance to not? Can I appeal? Can I just delay payment? (I’d rather not pay, but recognize I screwed up)

Any advice is greatly appreciated.

See also  Quit my job in home country in July 2022 and lost my local health insurance. Moved to the US (Illinois) in September. Got a job in February 2023 that doesn't offer health insurance. Am I qualified for ACA special enrollment? If not, how do I get insurance?