I cannot access the micro sd. It appears that the e250 cannot recognize it.

Sorry, it doesn't work that way. You can use a separate card reader to put files onto the microSD card. When the card is installed into the Sansa, the Sansa will see the additional music.

I believe you can fix it by going on the player, then to settings, then to USB mode, and switching it from MTP to MSC. If you're in MSC already and it fails to recognize, then I don't know. :(

I expected to find the new playlists on the SD card as a separate file to access and play. Instead the SD card songs show on up the Sansa menu simply added among the existing songs / artists stored in the Sansa. Its not a solution but they are there. Since using the SD card, my Sansa does databse refresh everytime it starts, whether SD card is in it or not.

make sure the card is 1 gb or less - a Sandisk card would be best since it's a Sandisk player

Check the Sansa tutorials at http://www.sandisk.com/Retail/Default.aspx?CatID=1468
to make sure you have followed all the steps first.

In my experience, every mp3 player/photo frame/etc with a card reader has a MAXIMUM memory limit for the type of card that it can read. It is possible that the Sansa player can only read 2GB Micro SD cards or smaller - and thisi nformation may not have been available when they printed the manual. If you have followed all instructions, and it still will not read the card, try switching to a 2GB Micro SD card.

you have to have mp3 files

According to what I've read, you can double the original memory, but no more than that, so the max you can have on a Sansa e250 would be 4 GB (2GB internal memory and 2GB external memory). I also read that the micro SD cards holds
music only-no video.

Go to the knowledge base on the Sansa site and find this (chances are you have an SDHC card in an incompatible unit):
Sansa e200 - verify the version of the player.  To check, go to SETTINGS > INFO. 
              
For 01.xx.xx firmware (e200 version 1) - up to 2GB microSD cards 
For 03.xx.xx firmware (e200 version 2) - up to 16GB microSDHC cards 
NOTE: Firmware is not interchangeable. 

Sansa e200R - up to 2GB microSD cards 

Sansa e100 - supports SD cards up to 2GB 

If music won't load onto Micro Sd card:
1) go to settings
2) go to USB mode
3)change to MSC format

Now you're good to go.

Try charging your mpr player first. -is your SD Card brand new and with warranty? I think its deffective. Return it for replacement.