How To Get Reimbursed For Healthcare Your Insurance Doesn't Cover

January 27, 2018 7:01 AM

I have spent a ton of money on therapists and doctors and treatments that my insurance doesn't cover. Is there a way to get reimbursed for this? Even partially? I have no out of network benefits. I live in NY state Thank you
posted by kbbbo to Health & Fitness (9 answers total)

In certain circumstances, medical expenses are tax deductible. You would need to itemize deductions (so you would need to do the math to see if that's worth it), and you could deduct anything over 7.5% of your income.
posted by brainmouse at 7:09 AM on January 27, 2018 [2 favorites]

Who would be reimbursing you? Most people don't get reimbursed for things like this unless they have that as a benefit somehow, maybe as a result of a work accident, injury caused by another, or maybe through their employer.
posted by amtho at 7:12 AM on January 27, 2018 [2 favorites]

Are these treatments things that you expected to be covered, but weren't? In other words, are these denied insurance claims -- claims you or your providers submitted to the company but had rejected? If so, you may have some recourse in NY state.
posted by halation at 7:42 AM on January 27, 2018 [4 favorites]

The short answer is: I highly doubt it. However, if you're low income and meet their qualifications, the hospital may forgive part of the bill, especially if you pay in cash. They will almost always set up a payment plan. Call their billing office, the number should be on your statements. This may not work for therapists or private practice doctors, though.

If you've already paid, and exhausted any appeals, then the answer is almost definitely no.
posted by AFABulous at 8:09 AM on January 27, 2018

Your insurance company is all about not paying claims. That said, if you have a condition that needs treatment, call them and ask for help getting covered treatment going forward. Also, call them and re-try getting reimbursed for every single claim, if you have even a shred of a case.
posted by theora55 at 8:21 AM on January 27, 2018

In your next enrollment period, look into signing up for a health care spending account (a FSA or HSA) if your employer offers these as insurance options. The terms differ, but a FSA, for example, will take a pre-tax deduction and put it in an account that you use for healthcare-related expenses that are otherwise not covered, like copays or eyeglasses—the items you’re talking about covering may very well qualify. The money is use-or-lose by the end of the calendar year, though some employers allow a small amount of money to roll over. An HSA is created as part of a high-deductible insurance plan, and you may only contribute while you’re covered by a high-deductible plan, but the money never expires and the account is yours forever, even if you quit that job or take other insurance.
posted by Autumnheart at 8:55 AM on January 27, 2018 [3 favorites]

As brainmouse mentioned above, the year that we paid $20K+ out-of-pocket in medical expenses we wrote it off on our taxes, including all pharmacy expenses. Since we were itemizing anyway we wrote off everything that was even tangentially pharmacy-related, like bandaids, aspirin, and vitamin supplements. You need your receipts. If you don't have them all you can get a summary receipt from your practioner(s), and you can even get summary receipts from pharmacies (I was able to get summaries from Costco pharmacy and also from my local grocery store pharmacy for example).

Check with your tax professional because if you're going to itemize you may as well itemize everything that you can.
posted by vignettist at 9:00 AM on January 27, 2018 [1 favorite]

Don't forget mileage too. If you have enough to itemize you can also do mileage to/from medical appointments.
posted by magnetsphere at 11:24 AM on January 28, 2018 [1 favorite]

I think you should be investigating whether your insurance will accept these as out-of-pocket expenses on your insurance. It’s not a reimbursement, but it will, if allowed, help you meet your OOP requirement.
posted by Thorzdad at 4:05 PM on January 28, 2018