Took on healthcare plan’s BS new co-pays and won

Hopefully this type of post is allowed, just wanted to share my story dealing with insurance BS and coming out victorious. Out of nowhere this year my plan started charging me a hefty co-pay for certain types of healthcare visits, when my plan documents explicitly said it should be $0, which was the case for two years prior. Contacting the company directly led nowhere as they just led me in circles and insisted that yes, even though they could not document it for me in the slightest, there's a co-pay because it's a virtual/telehealth visit, which made no sense. Ultimately they referred me to my employer's health plan reps, who initially weren't helpful either and just said "it is what it is"…that is until I replied back quoting state law, having researched the legality of charging different co-pays for virtual vs in-person care, which was very explicitly in my favor. And hmmm what do you know, one instance of proving I knew the law and a subtle threat of legal escalation later, the reps miraculously get back to me telling me my plan will reimburse me all the co-pays from past visits, with interest, and will make sure my co-pays are $0 as they should be going forward.

Moral of the story: don't be afraid to keep pushing when charges don't match up to your plan documents and/or state law. Whether the "error" was malicious or just bureaucratic incompetence, you'd be surprised how fast these for-profit corporations will fold if they understand they're gonna be in real trouble for doing x,y,z.

submitted by /u/21st_century_bamf
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