Long story incoming but really need advice.

24M making about $22k/year in Wyoming
My wife and I have been married 2 years. I’m still on my parents plan because I’m younger. My wife had her own plan. I’m working a lower end job and when she got pregnant, we qualified for our states Medicaid program. I thought “cool, we won’t have to pay $300/month for insurance anymore”. So, we go through all of the hoops to get Medicaid coverage. However, my daughter was born in late August of 2023 and coverage didn’t start until September 1st. We did self pay knowing that Medicaid would do retroactive coverage. So we got retroactive coverage through Medicaid to cover the delivery etc. So for the last 10 months I have talked to both Medicaid and Banner a million times. They always said it was “processing” and gave me a ton of work arounds but they both always assured me that we just had to be patient and it would all work out. They said they’d refund the amount we paid and bill Medicaid instead. They claimed that dozens of times. Eventually I called Medicaid and was super frustrated so they said they would escalate it and talk to Banner themselves since we’re coming up on the one year mark.

So… I get a call from Medicaid today saying they talked to Banner Health and they aren’t going to reimburse us since we did self pay at the time of service. I had to bite my tongue hard not to flip out on them. I hung up on the lady and felt like crying/puking. That’s a good chunk of our savings down the drain. They LIED to us for 10 months straight claiming it would all work out and now we’re out $7,000 because they aren’t willing to redo the paperwork. Is there ANYTHINT we can do?? Contact a lawyer, contact the governors office, contact an advocacy group? Anything?

See also  Challenge in HTA for gene therapies

Any ideas are welcome. I’m sick to my stomach over it. We were covered by my wife’s insurance at the time of service but we didn’t submit our claim to them because Banner and Medicaid swore up and down that they’d cover us.

submitted by /u/Storm12920
[comments]