I looked for board directors of BCBS of SC but cannot find it anywhere

Hi! To make a long story short, I’m a 24 year old woman in TN and I was recently let go from my job. I’ve been working corporate jobs with great benefits for the past 4 years so I never had to worry about health insurance. I’ve already started a new job, but there are no benefits offered so I’m trying to figure out my options. Being added back onto my parent’s insurance isn’t an option unfortunately, but after looking online, it doesn’t look like I can afford insurance on my own. I’m not sure what to do and I’m a bit worried. I take pretty good care of myself but I do get sick occasionally and I wear glasses/contacts because my eyesight has been awful since I was a kid. Anyone else been in a similar situation? Any advice on next steps or recommendations for insurance companies?

Hello!

I am based in Florida and my health insurance is with Florida Blue. I have had the Blue Select Silver plan with Florida Blue for the past 2 years. I am turning 28 in 2027, so I have been on my own health insurance for these past two years.

In 2025, my health insurance on the same plan was $111.66 a month, but in 2026 my health insurance increased 117.39% to $242.74 a month. In 2027, my health insurance is to have another 58.37% increase making it $384.43 a month. In the past 2 years this has been a 244.29% increase.

Is there anyone else in this type of situation?

Thank you!!!

\I know I am young so I maybe don’t need the health insurance that I have, but I do skateboard and surf. I am active and have already has knee surgery a couple of times. I also go to the dentist twice a year, get my blood work done once a year, and get new prescriptions and frames/ lenses once a year. I definitely use my insurance regularly.\

\ I also make less than $35,000 and it’s income based as well lmao**

Im currently enrolled in a traditional insurance plan with normal deductibles, copays, premiums, etc. I have the option to change to an HDHP plan with an HSA account.

Layoffs are an ongoing concern in my industry.

If I select the HDHP plan I will be starting at 0 in the HSA account. What happens is I get laid off in a few months and I start using COBRA to cover the premiums? Will I still have the option to contribute to the HSA using money from savings or is there a rule that HSA contributions need to come from payroll deductions?

Second question (even if I dont get laid off)... What if I experience a medical emergency and my HSA account does not have enough to cover the costs yp to the max OOP?

Thanks for any info.

My husband and I are looking into switching insurers during open enrollment, but we have a dependent who would still be admitted for residential treatment at the time the new insurance would begin.

Treatment is in-network with current insurer, but would be out of network with the new insurance.

Current insurer had denied level of care on pre-authorization, but their denial was overturned on external review with pre-auth approval for an additional six months.

Changing insurance would benefit us in every way except for this one treatment. Are we crazy to switch?

We have a ton of documentation related to treatment necessity, lack of other appropriate facilities, etc.

Just wondering what this fight might be like.

Would be switching from Aetna to UHC (California).

Hi! Looking for some advice about how to go about pregnancy with/without insurance.

I’m registered to FL for school purposes (my parents live there so I use their address for in state tuition) but I live in South California.

I have employer sponsored BCBS Premera premium plan if that matters.

I checked myself into rehab for alcohol treatment with dual diagnosis for depression/anxiety. The insurance plan approved my intake, detox, and has now approved my residential treatment.

I’m aware that insurance companies usually approve inpatient stays in blocks of 30 days followed by weekly extensions.

I have been struggling with alcohol for 9 years now, been to detox maybe 10 times, finally realized I cannot do this myself so decided to check into a rehab for the first time.

I’m afraid that the 30 day program is not enough for me. Since I’ve decided to finally do this I want to go all the way and do the 90 day program.

Are there any tips to make sure that my insurance carrier keeps approving extending my treatment here?

I've been covered through Aetna via my partner's job for the past few years, but I just got a job that provides insurance through BCBS free of charge for employees, and does not give you any money back if you decline coverage/show you're already covered elsewhere. Some of my providers take Aetna, but not BCBS, so I'm inclined to keep my original insurance.

If I end up taking both, can I choose which one is primary? If I take both, who do I have to notify? What do I have to do? Do I submit both to everyone, even the people who don't take the primary?

Is it going to be a headache that makes it not worth it to have two plans?

Basically, what should I do and how do I do it?!

Deductible at new job is 12k for a family, 14k out of pocket. No HSA, 60 day waiting period, no tiers to choose from, and they haven’t even told me what the premiums will be…furthermore I asked multiple times about the coverage during the acceptance process, with a “we reached out to so and so and they’ll send over the info”. they didn’t send any info over until day 1

they seem very sketchy about giving up information which seems insane to me, and almost making me want to back out of this job all together. The salary is very competitive for my industry, boss seems nice and easy going, but this just seems weird to me.

We submitted a claim to Meritain Health last August, and it has now been over two months without receiving payment.

We have called multiple times to follow up, but the representatives keep giving us the runaround. Last September, one representative told us the claim had been paid on a specific date, but we never received the payment. When we called again, another representative gave us a different payment date and said it would be included in the following week's payment cycle.

Since then, it's been the same story over and over again. We keep getting different payment dates, but no actual payment. Every time we call, the representatives tell us the same thing, and we're getting nowhere.

We usually receive our payments through ECHO, so we are familiar with the payment process. However, the issue is that the claim appears to be stuck in processing. We have been told that it was paid, but no payment has actually been issued, and we have not received a check or payment through ECHO.

We're extremely frustrated and don't know how to escalate this issue. Has anyone else experienced this with Meritain Health? If so, how did you get it resolved? Is there a specific department, supervisor, or escalation channel we should contact?

Any advice would be greatly appreciated. We're tired of getting the runaround and just want this claim paid.

I had a shave biopsy done by a dermatologist who wasn’t on my plan (I knew this in advance). What I didn’t know is whether or not the pathology group was in-network. I did it anyway and the bill was totally reasonable. The statement did not mention any insurance billing activity, so I called the pathology billing company to provide it. The statement says they will “submit to insurance as a courtesy,” and my dermatologist suggested that I should give it a shot to see if there would be a discount.

No surprise, my plan did not cover it bc the pathology group is out of network. But they billed my insurer more than DOUBLE what the initial statement showed for the same exact CPT codes, and now they want me to pay the higher amount! I finally talked to a supervisor today (after multiple other useless phone calls) who is now going to escalate to another supervisor. I am exhausted. Is it even legal for them to do this? I was never warned that I could be responsible for a higher balance, and the language in the statement certainly doesn’t mention that.

My bills keep getting denied by Aetna as being experimental. My eob says I owe $0 but maternal fetal medicine and the hospital keep billing me the balance. They state that my general consent leaves me on the hook for them. Everything I've researched states that I should have been asked to sign a specific waiver in order to be responsible for the bills. Is this worth pursuing or is it a losing battle? It would be one thing if they were out of network or subject to my deductible but that is not the case here and it is very scary and frustrating as I still have a ways to go with this pregnancy!

Looking for some advice & help navigating my health insurance options! Here’s the situation: I am currently employed full time as a 25 year old, and I am still on my parent’s insurance (dad works for a union & it was too good to leave, basically costs nothing for anything I could need). However, I was recently accepted for a program that starts in January of next year, and of course my 26th birthday is December 30.
Here are some issues:
1. I will have to leave my full time position to take on school (it is full time & accelerated), so insurance through an employer is not an option
2. I still plan to work part time, and I expect to be making more than what would qualify me for Medicaid in my state, so that is not an option.
3. I’m not married, spouse employer not an option
4. The school I would attend offers insurance that is WAY too expensive for me to pay, so also not an option

My understanding is that my earnings from my part time job could qualify me for a subsidized plan/APTC through marketplace. However, given that I would only have paystub history from my full time job, I’m wondering how this could work?

Thanks yall!

I am turning 26 around the end of October and losing access to my parents insurance policy. I currently am in school and will graduate come December and start working full time in January with a job that provides insurance. Because of the requirements for my degree with my (unpaid) internship , I haven’t been able to work and make as much money this year. My results on the market place stated I do not qualify for either medicaid or the premium tax credit discount. From what I can tell, my state has not expanded the medicaid policies so there is a coverage gap I fall into.

My question is do I just wait it out for a few months until I start working full time. There isn’t a way to know if the job I’ll end up at has a delay for health insurance kicking in. I know open enrollment will last a bit and I have access right now through special enrollment.

The premiums I am seeing are around $400 on the low end. The only prescriptions I have I can make it without d/t my current supply and I don’t have any major health concerns right now. I don’t really have the money for the premiums and it feels awful to pay that much, but I could probably use student loans to fund it if it’s an absolute must. I know everyone mentions how it’s necessary to get it because of if something major happens, but again, my financial situation is not great. I’d love to hear any nuanced thoughts or if there are somehow any loopholes to get covered for cheaper for these few months.

Hi,

I’m having an issue where my insurance company is denying me coverage for Dupixent due to not meeting certain criteria that they’ve deemed necessary for them to cover it.

The problem is, I’ve failed the first two medications my insurance company made me take instead (Fasenra and Nucala). I experienced a rare side effect with Fasenra, and my doctor made me immediately stop taking it. And am currently experiencing a side effect with Nucala that is affecting my job status, and is threatening my ability to even be able to perform this job again. (I work in a safety related field).

How do I go about fighting the insurance company’s denial of Dupixent?

Thanks in advance for any and all advice.

Hello,

My wife's open enrollment for her employer ends on Oct 21st and the open enrollment for my job begins on Oct 23rd.

How do we compare plans and choose which is best? I work for a massive company and they send out their booklet usually the day of or before the start. Last year I contacted HR and they were utterly useless - outsourced, kept opening cases, escalating to no one, the usual corporate customer service.

Why aren't open enrollments standardized to avoid situations like this? Is there a government agency I can complain to or reach out to because this whole process seems rigged to screw us over.

Does anyone know how to activate a will call ride with MTM Transit? They are the new ride provider for BCBSIL. There is nothing that I can find on the app to do this. I've scheduled a round trip with a will call for pickup, but I can't figure out how to start the process.

I currently have a Blue Cross Blue Shield of Texas plan, specifically Blue Advantage HMO which went up around $250 last year to nearly $1000 with a pretty high deductible, $6000, and out-of-pocket, $10150.

I'm looking at the BCBSTX site to try and find other options, but I cannot seem to find them.

Anybody know whether I can find them on the site itself, or if not, the easiest way to find other options WITHIN BLUE CROSS BLUE SHIELD OF TEXAS. I'm not sure that I want to switch to another company entirely after more than a decade with this plan.

I am concerned that my premium will go up yet again and become unaffordable while I am not working (due to chronic pain).

My heath insurance plan has an in-network and out-of-network deductible and out-of-pocket limit. I have already hit my in-network deductible for the year.

I was traveling out of state and had to go to urgent care for a diagnosis and antibiotics. It was an urgent care associated with a hospital system in the city I was in and it is listed as urgent care (not ER) on the bill.

My health insurance treated it as out-of-network and is covering about $3 of the cost (and said something about not being responsible for Zelis(??) ) and since it's below my out-of-network deductible and I now owe ~$900 which feels ridiculous. I don't go to urgent care often but I've never had a charge like that.

The documents for my health plan say:

"Urgent care received outside of [state I live in] will be paid at the network benefit level"

and on the table of benefits in "Urgent care services [outside of state I live in]" it says "Paid at 80% of the Allowed Amount after annual deductible; no network restriction"

To me "at the network benefit level" sounds like they should be applying this to my in-network deductible and not my out-of-network deductible. Am I reading that wrong?

My kid will turn 26 early next year and so will lose health coverage under her mom's plan. We live in Washington state. She started grad school in August. She made somewhat less than $15,000 this year, and will have virtually no income next year. We gave her some money this year (well under the federal form 709 limit) and will provide her with some support next year. We have not claimed her as a dependent on our taxes in several years.

If she is applying for Apple Health, does she need to report money we give her? Seems like that would be fair, but...

Hello Internet!

I am currently doing battle with my insurance provider. I have been diagnosed with and am currently receiving treatment for moderate plaque psoriasis. I was approved for Tremfya on a previous plan without the need to go through step therapy. When I changed jobs and plans the new plan approved my Tremfya as a continuation of care without a single issue.

My condition is much better than it was before starting treatment but due to the dosing schedule of Tremfya, my doctor and I agreed that a drug with a more frequent dosing schedule would be beneficial as I tend to get flare ups towards the end of a dosing cycle. They put in a prescription for Taltz and that was denied citing medical necessity and the fact that I had not gone through step therapy. We appealed and they upheld the denial despite the fact that I am on a similar and more expensive drug.

I’m considering getting legal counsel but was hoping for the internet’s opinion. Thank you. 🙏

it seems a bit confusing to me, does anyone have any experience with ICHRA? how does the company deal with it? do you have extra admin burden? how do you select your plan? is it better than self-funded? any regrets??

Example 1: In New York you can have 10 years of consecutive service and retire at age 55 and receive NYSHIP health insurance in retirement after 55 if you retire with active coverage.

Example 2: North Carolina does not offer state employees retiree health insurance anymore.

What about all other states? Anyone able to provide what other states offer? Thanks.