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Aetna - Why does it say I spent zero towards my out of pocket max when I spent $5 yesterday?
I have aetna cvs hmo. On the app it says I spent zero towards my out of pocket max which is not true since I went to an in network urgent care yesterday and spent $5 for my copay! Once the out of pocket max is met, then insurance covers all medical costs. Also when it says that my insurance will cover 100 percent for all medical services that are covered..when it says covered does that mean covered as in network providers?
MetLife Pet Insurance - undisclosed fees
I recently had to cancel my insurance policy within 24 hours, and I was charged a $12 enrollment fee. Dianna, a manager from MetLife Pet Insurance, mentioned that while they will refund the premium, the $12 enrollment fee is non-refundable and isn’t included in the premium. Just a friendly heads-up for fellow pet owners!
Priority Health - Two Private Insurances?? (I’m naive & I don’t understand insurance math)
I’m new to the private insurance world, so if anyone knows the answers to these questions, I will take any bit of knowledge given. Here’s what I’m working with:
**-Priority health - HMO ($1,300 family deductible) -Through my employer, Corewell Health**
**-State of Indiana Anthem - Healthsync POS with HSAS - ($6,000 family deductible) Through my husband’s employer in the state of Indiana**
* ***How do deductibles work? Policy states "You have to meet the deductible before coverage kicks in"?***
\[I’ve had Priority Health since 1/1/25 (Anthem did not become active until 3/1/25). Priority is saying I have met my family deductible of $1,300 but I am positive I have not paid anything remotely that close in office visit copays or on prescriptions. I’m happy about this, but it seems to me that I had some sort of coverage since the deductible is already met.\]
* ***Is it beneficial to notify both insurance companies so that they are aware of “the coordination of benefits”?***
* ***Can I pick who my primary insurance is (for doctors' appointments and prescriptions)? Or does it not matter who is primary and who is secondary?***
\[I might be speaking too soon, but despite the higher deductible, it seems like my husband’s insurance, Anthem, is better.\]
* ***Insurance math…??***
I recently picked up a prescription, and the pharmacy processed the insurance claims as follows:
* Priority Insurance (primary): $15 copay
* Anthem Insurance (secondary): $11 copay
The pharmacy combined the two insurances and calculated the total copay to be $7. I'm unsure if this was processed correctly.
My question is, with two private insurances, shouldn't the prescription be covered in full, resulting in a $0 copay?
Additionally, will I still be responsible for paying an office-visit copay for in-network doctor visits under both insurance plans?
\[My logic is that if I'm paying full premiums for two insurance companies, I should receive full coverage between the combined two insurance companies."\]
* ***Do I have to run both insurances when filling a prescription?***
\-My husband is prescribed disposable insulin pumps, which required a prior authorization. However, the PA process took months to complete due to communication issues between Corewell Health and Priority Insurance. Fortunately, his disposable insulin pumps are now fully covered by Priority Health. Here's the question: Until the prior authorization expires, is he required to file claims through Anthem when picking up refills? Note that Anthem became his new insurance provider on March 1, 2025, through his employer, and was not involved in the current prior authorization.
\[There are numerous prescriptions that Priority Insurance refuses to cover, but Anthem will. It seems like having to use both insurances could be a double-edged sword. The primary reason I have two private insurances is to mitigate the issues with prescription plan exclusions. Specifically, one insurance company will cover certain medications that the other will not, and vice versa.\]
Progressive - Progressive Snapshot with Tesla FSD
So we now know one of two things - either snapshot is designed poorly or FSD brakes too hard in a model 3. I don’t use anything except FSD and the best I’ve been able to score is 4 out of 5 stars all because of what it thinks is hard breaking - apparently snapshot isn’t designed for autonomous driving. PGR , time to wake up!
Progressive - Should I appeal an at-fault accident determination?
Hey everyone, looking for some advice. Back on February 6th, I got into an accident when the roads were icy, and sleet was coming down. I was driving under the speed limit, but my car swerved and I stupidly slammed the breaks (didn’t know that was literally the no.1 no no) and ended up swerving into a different land and a truck ended up hitting me on the passenger back side. The car was totaled.
Fast forward to now—I just got a notice from progressive saying I was found at fault. They included a form where I can contest it, but it costs $50 to do so. The form asks me to describe what happened, including the weather conditions. There was a decent gap between when I stopped swerving and when the truck hit me, so I feel like I might have somewhat of a case?
But even then, is it even worth sending the $50, or is it just a formality with no real chance of overturning their decision? At the scene, the police told me the other guy had a dash cam, and I don’t have any other proof that I wouldn’t be at fault. Also, would this at-fault ruling impact my insurance premiums down the line? Appreciate any insight!
NYSI - What does car insurance pay for after an injury? NYS
I got hit by a car last summer in NYS and was told by my lawyer that they’d reimburse for taxis (up to $25/day) and personal help needed around the home and stuff.
I kept all my receipts including for things like a walker, shoe lift, etc (I only got crutches through the doctor).
Now the insurance company won’t reimburse any of it because they said:
1- they only cover taxis to doctors appointments
2- they don’t cover laundry because that is “personal”
3- they won’t cover any medical things because I didn’t have a prescription for them.
These probably are the rules and I’m mad that my lawyer didn’t actually tell me this before and told me the opposite because I probably could have gotten a prescription for those items. But I want to make sure.
Trupanion - Just got a denial from Trupenion and wondering if I should just cancel
The claim was for dental surgery
(periodontal disease). The reason it was denied is that the cat had no previous medical records showing his dental condition. They also said that no single exam is going to be enough to establish he didn't have previous dental problems, they need to see a record of his health over time.
I do realise that dental is a separate category as far as most insurence companies are concerned, but I also wonder if they won't use the same reasoning in future claims. How can I prove something wasn't a preexisting condition if I don't have records?
Some background: My cat who is now 8 year old, grew up as a partly feral street cat in a non western country. Yearly vet visits for cats are not common practice there, and with him being the kind of cat that requires sedatives in order to get in a carrier, he ended up visiting a clinic even less than the average cat.
In short he has barely any medical records from before arriving in Canada last year.
I was actually a little surprised to see that I could even get insurance for a cat his age, but now I'm starting to suspect that they're just fine with taking my money but will never approve a claim.
TLDR: Should I cancel an 8 year old cats insurence if he doesn't have any previous medical records?
Mapfre Insurance - How long should it take for appraiser to asses damage?
Hello. I have mapfre insurance. I had a minor accident 2 weeks ago and submitted a claim on March 27th. They had me take pics of the damage(front bumper damage) I got my estimate from their electronic appraisal. I dropped off the car at an in network shop on Sunday, March 31st.
That Monday the shop submitted a supplemental appraisal to have someone to check the car to approve more funds to get the car fixed from insurance. Since then there has not been an appraiser to come check my car at the shop. It’s been a week and it’s beginning to get frustrating. I was told many different stories on when an appraiser will come up until on Thursday an appraiser told me there was an issue in their system that prevented them from assigning an appraiser. I was told this past Friday that one has been assigned and will call the shop to schedule an appointment.
The damage is minimal and the shop can fix the car in 2 days but can’t proceed without insurance. What are my options to make sure they have someone come on Monday? I’ve been without a car for a week and it’s been difficult to get around. Would love some advice on this issue!
PetsBest - Thoughts on this insurance appeal for PetsBest
Recently, my cat had to be rushed to the ER due to urinary blockage (FLUTD) , I submitted his bills, which rounded up to 7k, but the insurance denied it as pre-existing.
* Pet had not prior diagnosis or sign of illness in the past with a clean record
* Vet stated that he had issues peeing in an instance of stress due to construction and not due to FLUTD, and recommended Feliway Diffusers
* Vet also wrote a letter for me specifying that the symptoms were not related to pre-existing FLUTD
Now at the time that he started to show symptoms of blockage and straining the policy was already active and the waiting period was over. Am I crazy for thinking that them using past symptoms that were specified to not be related to deny my claim is actually wrong, and this emergency should fall under coverage?
Nationwide - Insurance just jumped from 500/year to 950/year for my 5 year old goldendoodle. Is it worth it?
Trying to figure out how much longer I should justify purchasing insurance for my goldendoodle. He is very healthy, not overweight. But I do have some pricey allergy treatments for him a couple times a year, but doubling his insurance is crazy! Any recommendations? \*\*Nationwide pet insurance\*\*
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