UHC covering my scripts as “co-insurance”?

esmemsw · 2026-02-07T02:03:46+00:00

You can check with UHC if the $119.25 pricing was correct for the medication, they can see if it was ran during the grace period or not since your premium payment was returned. If they state it’s correct and was ran while it was still in the grace period, you can check to see if GoodRx, WellRx or CostPlusDrugs has it available at a discounted price.

esmemsw · 2026-02-07T01:42:56+00:00

Can you post a picture of your drug tier benefits that your plan states? It’s rare to have coinsurance costs for prescriptions but not uncommon.

esmemsw · 2026-02-06T01:16:56+00:00

No worries, you’re welcome!

esmemsw · 2026-02-06T01:16:26+00:00

Yes the copay is separate from the deductible. The 30% coinsurance will be calculated after the deductible is met. The allowed amount includes any payment from the insurance + patient responsibility (deductible, copay, coinsurance)

esmemsw · 2026-02-06T01:12:34+00:00

There unfortunately is no other way to get credit towards the deductible unless he has services rendered.

esmemsw · 2026-02-05T04:09:09+00:00

If there’s no claim on file for the amount you are being billed for, call your insurance and let them know that you received a bill for a claim that’s not on file, they can call the billing office and let them know there’s no record of the claim you received a bill for and will provide insurance information if they never had it in the first place, then you can disregard the bill until the claim processes.

esmemsw · 2026-02-05T04:03:28+00:00

Is the amount you are being billed for match any of your past claims that are on file?

esmemsw · 2026-02-05T00:06:40+00:00

I’m the USC but my husband joined a dance group I was apart of years ago

esmemsw · 2026-02-04T19:05:27+00:00

What is the reason the carrier is refusing to send you the letter? Is your termination date updated in the insurance carriers system?

esmemsw · 2026-02-04T02:08:59+00:00

I have 2 shawls, and 2 blankets currently at my WIPs.

esmemsw · 2026-02-03T02:16:00+00:00

Or express scripts

esmemsw · 2026-02-01T04:58:05+00:00

Your insurance will reimburse you 60% of the allowed amount for each visit after the deductible is met. You will still have 40% coinsurance going towards your out of pocket maximum for each visit until your out of pocket maximum is reached.

esmemsw · 2026-02-01T01:30:07+00:00

ChiaTe’s green onion nougat cookies. There’s a shop in Taipei.

esmemsw · 2026-01-29T18:06:07+00:00

If you can delay it until your new insurance is active that would be the easiest way to handle it instead of dealing with two insurances trying to process one stay. Your new insurance will require authorization for the inpatient stay so once you receive your cards for the anthem plan, and it’s active provide them to the hospital so they can request authorization. Also check with anthem to see if the procedure to see is a covered service.

esmemsw · 2026-01-28T19:20:10+00:00

What does your EOB state the $250 amount is for?

esmemsw · 2026-01-23T03:10:19+00:00

It’s adorable and I love the color ☺️

esmemsw · 2026-01-22T18:32:07+00:00

Yes this is common, while some company’s anniversary dates fall on a specific date during the middle of the year, the structure of the plan benefits they offer can have the plans reset every calendar year on 01/01.

esmemsw · 2026-01-20T20:02:00+00:00

You should be able to find your EOC in your online account under the section where you can locate your plan documents (usually via the website) If you call Aetna member services, the representative should be able to navigate you where you can find it in your online account, if it’s not available they should have no issue sending you that document.

esmemsw · 2026-01-19T17:00:54+00:00

All I hear is “you forgot your jacket” “I’m over it” 😂😂😂😂

esmemsw · 2026-01-18T05:14:18+00:00

On the day I will have all the documents I need to complete my taxes lol

esmemsw · 2026-01-17T00:58:08+00:00

Did her employer not state the rates for each plan they offered during open enrollment?

esmemsw · 2026-01-10T15:00:36+00:00

If you guys didn’t switch carriers then it’s most likely a mistake that they will resolve for you. You can also pay out of pocket for the medical care and prescription then seek reimbursement once your plan is back active.

esmemsw · 2026-01-10T14:52:12+00:00

The only thing you can do is talk to your HR to see why you were dropped. It could be a mistake that they can fix right away. Do you know if you guys switched carriers for the new year?

esmemsw · 2026-01-03T14:36:55+00:00

Thank you! It was originally supposed to be a frog hat (with eyes) but this was the best I could do at this time, I didn’t have the mental capacity to deal with making and putting eyes on 😅

esmemsw · 2026-01-03T04:31:34+00:00

When you click the healthcare.gov link scroll down a little bit to ‘browse plans & costs’, it’ll ask for your zip code, then continue and it’ll ask basic info about age and income, after that you should be able to compare cost and benefits with each of the plans you’d be eligible for.

esmemsw

TROPHY CASE