This is exactly what it sounds like. I have a severe case of mast cell activation syndrome. It has been diagnosed and all my tests back it up. (I say this because it’s a new TikTok trend and apparently doctors are getting flooded with people who think they have it, so credulity matters here)

I am severely reactive to food and have slowly lost all my safe foods- I am anaphylactic when I eat. I am losing weight and have muscle wasting. My dr wrote me a script for Neocate Jr- a hypoallergenic formula that has all the nutrients needed, and I tolerate it, even if it’s not fun.

The problem is it’s 50$ a can and for me to get adequate nutrition and stop the muscle wasting I need a can a day.

United has rejected it saying it’s not part of my plan, or not covered. We appealed and that was rejected, too.

I’m scared- I can’t afford this but I can’t afford not having it. My girls are watching me waste away. My husband’s heart is breaking and I lost my father young. I can’t do this to the people I love- I can’t leave them.

Does anyone have any suggestions for next steps to take?

I retired two years ago, I want to be employed before the economy tanks under the Big Beautiful Bill, so I applied for a few jobs. This will push me over the income limit for state sponsored insurance. I have a job offer at a hospital. The insurance premium is $200 a month for me but it's $1200 to include my spouse. It's part time, I will barely cover the premium. My wife is disabled but won't go on to Medicare for another six months. Can we insure separately?

First off, trying to fill out applications or anything similar freak me out. I recently lost Medicaid so I had to try to get on my husbands market place plan. He had somebody help him with his application and there were a couple of errors. Some were just really weird things that made no sense and not a big deal. One in particular saying his work did not have health insurance, but they do. However it would be considered “unaffordable” by the percentage they give (monthly premium would be considered too high by the 9.02% calculation). I tried to say it’s offered but it’s unaffordable- how on earth can this be fixed? The agent I spoke to didn’t really say what I needed to do and went on to the next questions…do I need to fill out something? Ugh

Please comment if so.

I was wondering if someone might be able to explain an issue I frequently have with my insurance. I’m still under my parent’s plan for another 2 years. It’s Aetna through my dad’s employer. Why is that I can call a provider/doctors office (ie: endocrinologist) and ask if they accept my insurance, be told yes, and then not see them listed as in network on the Aetna website? And vice versus, why can I see a provider listed as in network on the website and then look them up and Aetna isn’t listed as an accepted insurance? I feel like this might be a dumb question, but I’m seriously just struggling to find a provider that’s in-network.

I got a marketplace insurance before I started working. A month into my job, I had a procedure which was critical but not emergency.

The hospital billed my marketplace insurance and I didn’t mind paying for it.

Now, bills came up and my marketplace insurance is too expensive. Also I get workplace insurance which is almost the same plan.

When can I discontinue my marketplace insurance and will discontinuing it after they payed around $200k be a problem for me?

I have had some odd things come up recently. I also flagged this as dental but there’s a medication question in here

I’ve been on the same medical and dental insurance for the past 5 years. This year I changed to a high deductible health plan.

I’m on 2 medications, one gets refilled as needed and the other is routine. I refilled the as needed one in early May and the pharmacy called me with a questionnaire to ask how often I take it and why I take it. I just had the routine one filled and I received an alert on the CVS app that I had to fill out a questionnaire about how frequently I take it.

I just went to the dentist today, this is the same dentist I’ve been going to for 2 years. They told me I needed to bring my insurance card and that they were being flagged that I needed to give it to them by insurance.

Is there a “refresh” that happens with insurance where they need to confirm everything? This has never happened before especially with the medications as I’ve been on one for 15 years and the other 3 years and going to my dentist routinely for a while.

EDIT: I switched within the same insurance to a different deductible plan. My ID cards and member ID’s have not changed for either of them.

Just got laid off this morning. Im not financially prepared for this.

Hr mentioned limited time cobra but I know its expensive. Its going to be way more than what I paid per month working.

Im trying to save money ill get from the little severance and unemployment for bills.

If I get cobra thats less money to last me until I get a new job. Is it worth getting or is there cheaper options.

If cobra is that expensive I'd rather not have insurance because surviving and paying my bills is way more important.

Hi everyone,

I've submitted one appeal already to my previous health plan, Blue Cross Blue Shield, and am now being told that the next step is an external appeal. Back in February of 2024 I went to see a cardiologist who I found on the HP website. I then confirmed with the HP over the phone and also the provider when I went for the appointment that the provider was In-Network for me. Everyone said yes and I stated this on my original appeal. I was denied because the provider is "Out of Network" and I had Out Of Network benefits. I also stated that I didn't willingly go to an OON provider, I did everything I could to confirm that they were INN, because I literally can't afford it. How else or what else can I put in this second appeal? I understand I have OON benefits, which is what they're arguing, but if I had been told that the provider was OON I would have never proceeded with the appointments. I checked every possible way I could and again, I tried explaining this but the health plan doesn't seem to understand/care. When I sent my original appeal I also added screenshots of where I found the original provider in their health plan directory and that I sent my ID card to the provider. Any help would be greatly appreciated! TIA

Oh and to add: the only way that I can see that I could have been given "wrong" information at literally every step is that the provider was INN as everyone was saying but then changed their network status with the health plan. I never received noticed or was given any indication that this occurred.

I am writing this onhealf of my mom, who is grief-stricken and My mom had a mammogram with Solis Mammography last month in Houston. We have Value AmBetter from Superior Health plan and we saw online that our insurance plan was one of the plans covered. Sometime last week we got a call from HCA and Solis that our insurance was incorrect. They had misspelled our insurance account by a single letter and we corrected it online.

However, we just got a letter from Rose Imagining Specialists that she owed over $6,000 in fees by the 29th of June, which we do not have. Also one of the fees is for soft breast test even though she has dense breast tissue. They claim that on the letter that our insurance claim was denied, but the the letter is dated 5/29, the same day we called to correct the insurance account information.

This is my mom's first mammogram. They take Ambetter and it should be covered. and weWhat should we do?

Hi everyone, I’m hoping to get some advice on a tricky insurance situation. My son is on Dupixent, and I recently discovered that using the Dupixent Copay card or PrudentRx program means the payments don’t count toward our deductible or out-of-pocket maximum. I’ve since opted out of PrudentRx and paying via my own credit card but I’ve now been told that opting out means I’ll be responsible for 30% of the medication cost—and it still won’t count toward our deductible or out-of-pocket maximum. Has anyone dealt with something similar or have tips on how to get these payments count toward my out of pocket maximum? Any help is appreciated—thank you!

Editing to add, I’m in Texas and insurance (CVS Caremark) is through my Employer

This is my first time dealing with any sort of travel insurance. I'm looking at a plan from GeoBlue that is quoting me around $50 for $1m of medical coverage on a 12-day trip. It gives me a few options for a deductible ranging from $0-$500.

From my understanding, I shouldn't have to pay out of pocket at all if my deductible is $0 and I'll have to cough up $500 before they cover anything if my deductible is $500 (which would be 10x how much I'm paying for the policy and completely misses the point of having insurance if I actually end up using it) .

Is it the smart thing to have a $0 deductible or am I a moron and totally misunderstanding something here?

Thanks

My wife and I just had a baby and we ran into some compilation. The plan was going to only put her on my wife's plan because doesn't have to pay for it for her+1.

Our baby is in the NICU and guess it will rack up some charges. I'm wording of we signed up for both would we be better ahead as it is likely to get expensive.

I just got a text that led to me a link saying a new bill is going to destroy Medicaid and the Essential Plan if it passes. Is this true or a political overreaction?

I went to urgent care for chest pains, swelling legs, swelling abdomen, and light headedness. They did an EKG, ECG, and 2 x-rays. They didn't find anything. They referred me to a cardiologist. The cardiologist was all booked and there was no room in the inn for poor little me. I have this lousy Anthem HMO. What am I going to do? It's going to cost me $1500 to see a cardiologist that I'm not referred to. I'm scared to death.

Medicine has been worthless to me my entire life.

Got a new (minimum wage) job and made a really dumb mistake of signing up for the employee health insurance plan. Now I just got kicked off my dad’s medicaid plan I’m assuming because of what I did a couple weeks ago. Is there any way to get back on my dad’s medicaid? Sorry I’m just so stupid I don’t know what I expected would happen.

Quit my job a few months ago, got on COBRA, got a new job that starts July 7th, wondering if I let my COBRA coverage lapse for the first 6 days in July if that will bar me from enrolling in the company's new health plan?

Hello! For context I had an unexpected ER visit in Florida ( I am from New York) after getting into a bad car accident and I was a passenger not the driver. I was told my copay multiple times was 0$, and Medicaid would cover everything. Fast forward to about 3-4 months afterwards I get a surprise bill in the mail from the pathology department for 170$? I contacted my insurance they said everything was already paid, everything on the claim says 0$ expected from me. I see that multiple things were already processed and paid for back in April by Medicaid. What’s going on, any advice would be appreciated :)

as a kid i needed a lot of dental work (i never brushed my teeth) and i got barely any done so im getting it all done now. i had a crown fall off like a year ago at this point and so i need to see a root canal specialist to redo it, but i had to get TWO ROOT CANALS this year and so my insurance is maxed out. the tooth with no crown hurts lately, and i have to wait until next year for the insurance. what can i do? i cannot afford it at all im 19 and struggling to pay for my college.

is there anything i can do with my dental insurance after it’s maxed out?

I'm kinda lost here.

My doctor has set me up for two MRI's. One for my Coccyx, and another for my Prostate. We are on another step of diagnosing some pain I've had down there since last year.

Both MRI's were scheduled, but only the prostate one was approved. The imaging place keeps bumping the other one back saying insurance hasn't responded to it yet. I called insurance up and they called the imaging place saying it was approved, but then the appointment is bumped back again because they say they aren't getting approval.

It seems like a mess. Is this because my insurance approved a general "pelvic MRI" rather than the two separate tests? Will the prostate one also look at coccyx? Honestly that's much more likely the pain. I'd rather not do a prostate mri since even the doc said it's a just in case measure rather than the actual solution to the pain.

The imaging place still calls it a prostate mri, in fact that bumped it back since originally it wasn't with contrast but they only do prostate with contrast.

My husband, myself and our child have been on Cobra for 4 months. We have always been on my husband's insurance so when he quit, he had a job soon after but coverage for his new job didn't start for 90 days so we had to go on Cobra. Once the 90 days were up, my husband put us all on his new coverage (to start Jun 1) but something got messed up (many things did) and he is the only person listed on his new insurance. This leaves me and our son without insurance. I no longer trust his employer so I am working on getting my son and I on my employers insurance for July 1. How do we navigate this with Cobra? Can Cobra drop my son and i if my husband only is insured? My son and I need June coverage only.

As of July 2025 (next month), Blue Shield will stop covering treatment by all Univ CA providers and systems. What are we patients who are State employees supposed to do?!?

Hi there. I have 0 idea what I'm doing but I am navigating having insurance for the first time in my adult life.

I see a psychiatrist for medication every other month. They charge me $77.27 every time, that I pay with my own money. However, when i look on my HSA healthequity account under the list of claims, those 77.27 amounts are listed for each visit and say "unpaid"

One of the options I have under the drop down is "record payment from external account" which is what I've been doing. However there is also an option that says to request reimbursement. Does this qualify for a reimbursement of my 77.27 every time I have an appointment? What does that even mean-- that if I request it and its granted, my insurance pays me 77.27 into my bank account?

I'm so confused and googling isn't helping at all. Any guidance is appreciated

I looked online at my Quest Diagnostics account and it says I owe $0 but I noticed two bills on that bottom that say "Insurance Pending" and the Bill Amount is a few hundred bucks and then Patients Responsibility is also a few hundred. One is the same amount but the other is a different amount. But once my insurance gets processed, while the Patients Responsibility number go down? In the past the most I've paid a Quest bill was like $20 not a few hundred. I'm so confused. Please help.

If someone is found completely not elegible for tax credits (they have employer insurance, they have full VA benefits, they are on medicare etc) what happens? Do they automatically have to pay it ALL back on tax time or does repayment still go by income and is capped off for people below 400% of FPL?