Health Insurance trying to collect additional payment on co-payments that they undercharged.

[cyberrbt2019]

What is the name of your state? California

Anthem Blue Cross sent me a letter/bill stating that they undercharged me on some or all of my 2018 prescription drug plan copayments. They further said that the Centers for Medicare & Medicare Services (CMS) requires them to attempt to collect the missing copayment amounts and "Please rest assured that this matter won't affect your plan enrollment status.". They provided a telephone number to call if I have concerns about my ability to pay.

It doesn't seem right for me to be asked to pay because the pharmacy accessed the health plan's computer system at the time of purchase and obtained copayment amounts for me to pay (and I paid the requested copay).

Am I legally required to pay the amounts that they are asking for?

 

[Shadowbunny]

What is the name of your state? California

Anthem Blue Cross sent me a letter/bill stating that they undercharged me on some or all of my 2018 prescription drug plan copayments. They further said that the Centers for Medicare & Medicare Services (CMS) requires them to attempt to collect the missing copayment amounts and "Please rest assured that this matter won't affect your plan enrollment status.". They provided a telephone number to call if I have concerns about my ability to pay.

It doesn't seem right for me to be asked to pay because the pharmacy accessed the health plan's computer system at the time of purchase and obtained copayment amounts for me to pay (and I paid the requested copay).

Am I legally required to pay the amounts that they are asking for?

Yes.

 

[xylene]

What are the drugs? (and were they generic/ are there generics available)
How were the prescriptions submitted? (electronic, paper)
Where they written as DAW (dispense as written) or not?

How many prescriptions are involved?

What is the cost they are assessing you?

 

[cyberrbt2019]

What are the drugs? (and were they generic/ are there generics available)
How were the prescriptions submitted? (electronic, paper)
Where they written as DAW (dispense as written) or not?

How many prescriptions are involved?

What is the cost they are assessing you?

No prescription names or other details about the under paid copayments were given in the letter. The amount they are asking for is $121. The prescriptions were submitted electronically by the doctor and picked up at the local CVS pharmacy.

 

[cbg]

Numbers are examples only.

If your insurance contract says your copay is $15; you paid $15 and they are now trying to charge you a $20 copay, you do not owe the extra $5.

However, if your insurance contract says your copay is $15; through some error you were only charged $10 and they are now trying to collect the extra $5, then yes, you owe it.

Even if it was their mistake.

Even if they only charged you the $10 when you collected the prescriptions.

Even if you paid the $10 in good faith.