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.