Insurance changed coverage 2 years after bills/incident – need advice!

I had a baby in Mar 2022 using hospitals/providers/anesthesia in network with our Marketplace insurance (Molina). We had to adjust our coverage and premium a couple times that year due to the new baby and salary increases, plus had to pay for some retroactive coverages doue to a miscalculation on their end, but got all of it smoothed out by the end of that year (after months of excruciating hours-long phone calls woth Molina's agents btw).

Now, July/Aug 2024, we are getting bills from March 2022 and May 2022 for the epidural and pediatric visits, redacting the initial billed amount and now saying more is owed. We called the offices who said Molina took back some of the money they paid toward our bills. Molona confirms they did this, citing that we didn't have coverage at the time (we've heard from them we didn't pay premiums, never paid for retroactive coverage, etc – all incorrect). We just got a collections bill for $3.4k for instance, saying Molina only paid $4k of it when they initially covered it all except a $90 copay fee thing.

Just wondering if anyone knows if this is legal or if there are any grounds to be able to fight it? We are already calling, begrudgingly, Molina again trying to get an appeal worked out but they are such a mess that I am super worried things are just going to get more muddled than they already are. It's been over two years. The pediatric providers have a settle amount we could easily cover, but this anesthesia bill is way beyond what we can pay now. I just feel like we shouldn't have to pay out any more than we already have for our bills, especially now that its been so stinking long. I've had another baby since then for heavens sake, and we're getting those medical bills now too. Are insurance companies or providers held to certain billing timelines(ie. must bill within 180 days) or do they have free reign to "audit" and request more money on bills thought already paid (because they were paid in full, for at least 18 months) years down the road?

(For the record, we have changed health insurance companies. Never again!!)

26yrs old from Utah. $90k gross annual.

submitted by /u/aumblebee
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