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Kaiser Permanente - healthcare marketplace help?
Hi!
So I've enrolled into healthcare marketplace back in November, and I've hit a major health issue since then and my current healthcare provider is absolutely helpless and don't seem to care enough to help me ( I have Kaiser Permanente). Is there anyway I can switch insurances past the deadline (I know its so late now) but I'm quite fed up, and super frustrated. Any advice helps!
Thank you for reading\~
Trupanion - Starting policy early in life. Need help weighing different options.
I recently adopted a 1 year old Golden Retriever and I am attempting the long arduous task of finding the right pet insurance.
He is healthy and has no pre-existing conditions — albeit the one that will be documented once I bring him to the vet this week for anal gland expression (which isn’t covered by most insurance providers anyways).
I am aware of some of the health conditions that golden retrievers are susceptible to, including hip dysplasia and cancer. And, I know, based on first hand experience, that the breed is extremely accident prone. So I am opting to start the policy early to eliminate other complications from becoming pre-existing conditions if I wait till later in life.
At first I looked into Trupanion because I like the premium service of the provider paying vet bills directly (saves some headaches). And I like that it is on a per condition deductible basis, where each condition deductible can be met earlier in life. But I can’t get over some of the horror stories about increased premiums. I am financially able to afford such a service, but the rate increases just seem unreasonable.
I’ve also looked into Pets Best and MetLife. Are there any recommendations that you can make that I should consider? Should I just go with Trupanion?
State Farm - State farm homeowners insurance deductible
We recently had to file our first homeowners insurance claim in the 6 years we’ve owned our house. We had a huge storm with 75+ mph winds and torrential rains, tornadoes etc.
We randomly had the wood paneling in our living room (interior wall, other side is a bedroom) sustain water damage. It was wet and mushy and all warped. We want it fixed because we don’t want mold growing etc. roof is 4 years old so we aren’t sure how water got in. We also need a professional to figure out how this happened.
Anyway, State Farm says it’s covered under our policy.
We have a $3,000 deductible.
They said they deduct the deductible from the money they send us for the repairs. We don’t pay it up front.
(We are waiting for a callback from the contractor they helped us find).
To me that sounds like if it’s going to cost $6,000 to fix they take off $3k and we only get $3k.
My husband thinks we get the full amount for the repairs which makes no sense to me. State farm has to pay themselves the deductible.
We had a total loss on a car last year and they took the deductible out of that and we got less money back for our payment. So that’s why I think we aren’t going to get the full amount (which is not going to be helpful we don’t have a ton of money right now).
So anyone know who’s right?
unknown - CPT code confusion
I had an MRI arthrogram ( contrast for hip labrum and joint) and it was coded 27093, 77002, and 73722. And then the pharmacy drugs.
My insurance is trying to bill this a surgery as they say code 27093 is under the surgical code section in the CPT guidelines. Normally I would have 100 percent coverage for any outpatient clinic ( non hospital) MRIs. My insurance says even though this was not done at a surgical centre or with a surgeon ( only a radiologist), they can charge me as if it was a surgery and therefore also charge the radiologist as surgeon fees.
Does this make any sense at all? That way they say I have to pay 20 percent of the whole package of MRI ( 73722), Radiology diagnostic ( 77002) , and the local anesthetic used by the radiologist prior to the iodine injection ( 27093).
So even though my work insurance normally would cover radiology diagnostic and all imaging at 100 percent, they say because of 27093, this is now a full blown surgery and only covered at 80/20 rather than 100 percent.
Is this true? I will post in CPt code section.
Trupanion - Run like the wind from Trupanion
Trupanion raised by rate by 56% on my dog who is not yet 2. In other words, we've only had the policy for about 1 1/2 years. She continues to be in perfect health too, no claims. What a breech of trust! I've never missed a premium payment.
insurance - Back and forth between adjuster and contractor; no work done to my damaged home
Last year, my home was hit by a vehicle and became unlivable. I was advised to create a claim with my insurance company. I had a disaster restoration company come out, provide a quote, paperwork signed, my insurance paid out a portion of the estimated total, I paid the deposit to the restoration company out of that. That was six months ago and no work has started, and here is (allegedly) why:
1. My siding has asbestos. Contractor says they cannot fix the damage without disrupting the asbestos on the two undamaged sides, therefore insurance needs to pay for four replacement sides, not two. According to contractor, this is an EPA regulation. Insurance says because it’s not township code, it doesn’t matter and they will only cover two sides.
2. My hardwood flooring is original to 1950 and has no subfloor. The subcontractors won’t fix without installing subfloor, as the type of hardwood used in 1950 does not exist and today’s would not be strong enough. Insurance will only cover fixing the damaged area, which means I will have a visible difference and seam in the hardwood. Again, because it is not code, Insurance is pushing back.
I have not received an actual denial letter, I’m just being told by the adjuster that nothing is happening. I requested to escalate to a supervisor two weeks ago, still no updates.
I’m overwhelmed and I’ve been out of my home for more than six months.
Questions:
1. Do I need an attorney, and if so, what kind? Google hasn’t been helpful.
2. Am I within my rights to get a new quote for the siding and hardwood flooring separate from the other repairs?
3. Why is this going through my insurance and not the insurance of driver who hit the house?
I only filed with my insurance because I was panicked and a neighbor told me to, and I’d rather argue with the bad guy’s adjuster instead of mine. I feel like I have to play nice with everyone, but the anger and resentment and frustration is building.
GEICO - Could separate auto policy for 17F reduce premium?
I currently have an auto policy with only my teenage daughter (17F) after removing my STBX from the policy, but I feel like the premium for my car is higher than it should be and I'm wondering if there are any ways to reduce the premium. I am a 40M with a very clean driving record, my daughter had a claim last October where she hit a fire hydrant and the repair was \~$10k or so (no meaningful property damage to the hydrant). I drive a 2021 Tesla Model 3 and she drives a 2017 Audi A4 that her grandmother gave her. Total monthly premium with GEICO is $548 for my car and $366 for her car. I believe the average Model 3 insurance rate in Colorado should be closer to $300/month and I'm just trying to think of ways to lower my premium. Is it possible to separate policies and save money if I make it so that she can't drive my car and doesn't need to be insured for that? Any advice or ideas are greatly appreciated!
Optum Bank - Unable to use money in DCFSA
So, I was terminated in May of 2024 where I have a DCFSA account.
When I went to call Optum Bank, they said the employer allows 3 months of grace period (to August 2024) then terminates the account. Optum account follows this, and does not allow reimbursements from terminated accounts.
It looks like I'll lose this money.
Any thoughts?
homeowners insurance - In limbo with dog bite lawsuit.....
Location: Philly, Pa
Any ideas???
Back in July our dog bit our neighbor. One of the kids let the dog out, and he bit them. We knew from the jump we were going to get sued. We got a lawyer when we received a letter from theirs. They wanted our homeowners insurance info. Welp..... come to find out, ours doesn't cover animal injuries or damage. So, after a month or 2, they asked if we wanted to just settle out of court. Of course we did. They came at us with a settlement. We weren't able to get the full amount but came back to them with a lump sum right away then asked to make 2 monthly payments to settle the rest. After weeks, they declined it and we received a letter from a new attorney asking for our homeowners insurance. Ummm... we already told them we didn't have coverage. So, our lawyer was going to get with them, we paid him another retainer (ughhhh), and he told us there was nothing to do as of now until he hears something. He said he would get back to us. It's been 2 months and still have not heard anything.
What is going on???? Like we were going give them exactly what they wanted. They were just playing with us I guess and now we just wait???
Any ideas on why the wait game? I just want this over with. And just in case you all want to know, we are not made of money. We have 2 kids in college and 2 little kids. We live pay check to pay check and had to get a loan to pay the lawyer and that settlement they first asked for.
It was a totally misfortunate accident, we were devastated for them, and are deeply sorry. We are good people with a good family.
Thanks
Farmers - Waterproof Vinyl Question
I just had a pipe bust in my attic that flooded my home for about 40 minutes before it was stopped. It’s ruined the insulation in my attic, all ceilings in 80% of my home, the walls, and the baseboards. The adjuster (farmers) is saying the floors he believes are waterproof vinyl therefore took no damage and can be dried out. When they removed the baseboards i did go around and see the corners of the floors are peeling up and have water under. It is continuous throughout the whole house with no breaks. I tried to google and can’t find anything on this issue, has anybody dealt with this before? Can vinyl floors have no damage under? I’m a new home owner and I have little knowledge in this, thank you in advance!!
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