The patient is enrolled in the Moda Health Beacon EPO plan, and the provider is listed as participating in the Beacon network. However, the claim was denied by the payer, citing that the provider is not a participating provider. Could you please clarify whether participation in the Beacon network includes all plan types such as PPO, HMO, and EPO?"

I have read some prior threads for this but they are from a year ago and I'm curious if there have been any changes. Background: I have had UHC and used Optum for my specialty pharmacy for years. My specialty medication is a biologic with no generic equivalent. The manufacturer provides me with both a copay card and a payment card. My deductible has consistently been met in January every year using the payment card, and then the copay card picks up the copay for each month for the rest of the year. Situation: This year, the manufacturer payment card was processed as usual and applied towards my deductible, however, they went back a few weeks later and reversed it from my deductible. When I called them, they said nothing has changed and the payment card, as a form of manufacturer assistance, cannot be applied towards my deductible, despite that having always been the case. Based on what I have read about an HHS ruling, they are required to apply this towards my deductible as there is not a generic available. I filed an appeal and was denied. My employer plan is likely self funded, but from what I have read, that should not matter. Has anyone gotten a resolution to this issue?

Hi everyone. I brought my 5 and 9 month old kittens for a wellness exam this morning to show there are no pre-existing conditions to Trupanion. The vet ended up noting that there was a very small amount of tartar on just one tooth of each cat, and it was so mild she didn’t even know if it was just food residue or tartar. It also took her multiple tries to even see it. She did however note that the dental score for my cats are both 0, meaning there is no sign of disease or tartar (?). Trupanion is now saying that for the rest of my cats lives, any dental issues (other than accidental breaks) won’t be covered since it is a pre-existing condition. I’m at a loss for what to do… I know cats often need extractions and I chose Trupanion for their dental coverage. It is so frustrating that because of that one finding that was so mild, nothing will be covered. Does anyone have any experience with this and any advice? I’ve read somewhere that someone had their vet write a note saying it was not a pre-existing condition. Has anyone else heard of this?

I totaled my car and I was on fault even tho the other driver actually was also speeding, but after that Progressive told me they are only covering liability and not giving any money for my car since I was driving for work purposes, (I do patients visits, which for still counts as a commute). They argue that I did not specify that I used my car for "work" which in their policy options that options doesn't exist, and this is not tagged as for business purposes. I want to know if is there legal advisor or way to fight against it in Ohio EDIT EXTRA My policy only asks what the primary use of my car and it only gives to pick up one option. Doing visits is not even the 30% use of my car The primary use of my car is actually personal use and commute to my office, I only do in person visits usually 2 a day, but not every days of the week as I do also online visits.

We first joined at around $30 but it is now $150 just 3 years later! While I appreciate that they respond through email, will make up reasons for care reimbursement rejection - and they don't seem to have a transparent appeal process!

pretty pissed tbh...my corgi went through a bad bout of emergency diagnostics early this year, all covered by nationwide at the time. He went back recently to have a recheck, sent it into nation wide like I had already done, suddenly it's denied. I did the review request and provided tons of documentation from the doctors. they claim its preexisting, and also went and retroactively said that all of my other claims shouldn't have been paid out. He was diagnosed with protein losing enteropathy, and they're saying that because he "vomited" earlier in the year (our first sign), thats preexisting. This is insane. Cancel your shit before you have an emergency and it happens to you

I feel like the obvious is “absolutely have one.” But friends and family make it feel like a total scam because they’ve had such negative experiences with every alarm company. What are your experiences with home security companies and do you feel like you got what you paid for in regards to home security? (For reference, growing up my parents always had ADT and had such a terrible experience that my dad ripped the monitor out of the wall and told the customer service rep some vulgar things about what he’d rather experience than do business with ADT again). For home security of course I’ll pay the extra price, just want to make sure it’s actually worth it and that they come through for you in the event of emergency.

What happens if I don’t pay my cancellation fee from my last auto insurance company? I cancelled it before the end of the policy for the same coverage at a different company for more than 200 dollars less a month. I didn’t realize I would get a cancellation fee it’s not much but out of principal I don’t see why I have to pay this since I paid the whole month in full and cancelled before the end of the month if anything they should refund me for the days I didn’t use. they’ve been calling me and emailing and snail mailing me everyday for payment. What happens if I don’t pay the cancellation fee? All I’ve seen online is they can cancel your coverage but my coverage is with a total different company now so they can’t cancel that. Would it go on my credit report somehow?

Can someone help me with Lemonade pet insurance? My pet policy is 80% reimbursement, $250 deductible, $10,000 annual. My dog went to the vet to get a mass checked out and got bloodwork done. My plan doesn't cover exams or bloodwork. Cytology was $185 and fine needle aspiration was $40. In this case, the eligible cost that would go towards the deductible is the cytology exam and fine needle aspiration, which adds up to $225. I was under the impression Lemonade paid out 80% AFTER the deductible is met. But Lemonade just got back to me, and it shows that they covered 80% of the $225, which is $180. Which means I still have to pay $70 until my deductible is met, instead of $25. I thought the 80% was only for reimbursement after the deductible, not 80% coverage of the deductible. Is this how all pet insurance work?

Hey guys , so this happends to me , My son was involve in an car accident last year (few months ago). He was driving his scooter to school on a traffic light he make an line change and got hit by a car(He is a Minor).After few days we got the police report saying that was my sons fault. Nearly January I receive an letter from NCS saying that I need to pay them 14k！The insurance of the other guy was nationwide. It was just a small accident so this looks not normal to me. Being an minor and on an scooter on his way to school hitting by a car was very stressful and know we need to pay over 14k out of my pocket. Just want to ask if NCS a scam? Should I pay the balance?