Hi all, I'm leaving my current job and I have another position that pays higher than where I'm at right now, but no employee health plan. I'm in CA. Right now I'm looking at marketplace plans for my spouse (33M) and I (31F). We don't use much when it comes to health care. A few random visits here and there, I take a few daily mental health meds but that's it. However, we do want to start a family in the next year so I'm trying to keep that in mind. I've always been on an employer PPO, so that's what I'm used to. My top options currently are Blue Shield of CA PPO, or Kaiser Gold HMO. From what I've seen blue shield is one of the few companies that will offer PPO on the marketplace. I've looked at some of the cheaper plans through multiple companies but since most of them have coinsurance, I worry I could rack up quite a bit if I were to get pregnant/deliver. We earn too much to qualify for financial help/ACA plans as well. Here's my question - how much does Kaiser's HMO plans differ from their PPO? Is it really a big difference since it's all in one system? I know there are issues with Kaiser and it seems people either love it or hate it. But it seems like their HMO plan is cheaper with better coverage (particularly for maternity) than a similar PPO through blue shield. Anything I'm missing here? Any advise or prior experiences would be helpful.

Location: Virginia I live in Virginia — a state where “as-is” sales are firm, but not completely lock-tight. I bought a 2015 Chevy Silverado 1500 from a small used car dealer less than two weeks ago. It was sold “as-is,” but the salesman promised a 90-day free warranty at the time of sale. Later, I was told it wasn’t added because he had “already paid processing fees.” Four days after purchase, the transmission started acting up. By day five, it was shuddering, slipping, and losing power. I took it to a trusted transmission shop, and they dropped the pan and found a significant amount of metal shavings — consistent with a problem that had developed over many months. This wasn’t a sudden failure — it was clearly a pre-existing issue. I thought I was covered under the extended warranty I believed I was buying through my loan. Turns out that warranty (Route 66) denied the claim, stating the damage was pre-existing. Here’s what I’ve done so far: •Filed complaints with the BBB, Consumer Protection Agency, and the Motor Vehicle Dealer Board •Reached out to several lawyers — I’ve got two consultations scheduled, but they’re still a ways out •Still struggling to find an attorney who handles consumer auto fraud/litigation in my area •Tried contacting the dealership multiple times — I’ve: •Called both numbers posted on their door •Left voicemails •Emailed •Messaged them on Facebook •Even stopped by in person — no one was there •The last thing I heard from them was “follow up after the diagnosis” — and nothing since •I’ve also requested cancellation of the warranty since I feel it was misrepresented and clearly not helpful Now I’m stuck using money that was supposed to go toward my loan to cover the canceled warranty and looking at paying out-of-pocket for a major repair. At this point, I feel completely stuck. Has anyone else been through something like this in Virginia? Do I actually have any legal options — or is this just one of those expensive, awful life lessons?

My ex cancelled my elderly chihuahuas health insurance (the anger I’m feeling is palpable in other countries). I have a 13yr old chihuahua Peanut 🐶He was covered by Trupanion for the last 6yrs or so until my ex let the insurance lapse last month without telling me. I tried to reinstate but Trupanion said I missed the 3 day period. Peanut has lots of existing conditions (galloping heart, epilepsy, pre-kidney disease) that without reinstating Trupanion won’t be covered and someone even mentioned he may be uninsurable, like some places won’t even accept him at all. I’m very panicked. Does anyone have any advice on getting a policy reinstated?

I asked the Doc to send a simple urine sample to Quest. My insurance covers 100% labs with Quest. Today I see on my Florida Blue Cross account they sent it to a different lab and my portion is $3170. What to do?

I am located in the US and like the title states my PHI was shared from my companies absence manager (Sedgwick) to my employer. Essentially someone at Sedgwick forwarded all my documents needed for the leave to my employer and they retaliated against me by accusing me of being too sick to return to work even though my doctor cleared me. This went on for about 10 months before I was allowed to return. I spoke with a representative from Sedgwick on a recorded line and they stated it would be against the law and HIPAA to disclose my records with my employer beyond the fact I was approved for the leave. I am in a high earning job ($150,000) and lost out on nearly $120,000 worth of wages during this time. Would I be eligible to sue Sedgwick for the lost wages considering I was cleared to return to work and my documents were leaked to my employer resulting in retaliation and harassment?

I adopted bonded pair of kittens and got them on pet insurance with trupanion at 8 weeks. They just turned two and trupanion has increased my premiums by 70 % in those two years. I understand they don’t raise the premiums based on pets age, but at this rate I won’t be able to afford to insure them until they get old. Looking at switching to lemonade - my one kitty has two minor claims and my boy has none. I realize her two claims will be pre-existing but they aren’t chronic issues. To the cat parents with lemonade- do you like it? Are you happy? I know I risk their premiums rising as well but at least I can afford more coverage with a smaller deductible to start. Would love your thoughts I want the best for my babies!! Thank you

I’m moving out of NY to another state soon for my masters and the school requires that I either have full coverage health insurance or I purchase theirs which is $4,500+. Is there any health insurance plan either in NY or nationally that I can enroll in which would allow me to be seen for any medical purpose out of my home state? My current insurance is health first but it is an HMO which only allows me to be seen at UC/ED for emergent purposes only. The school requires non-emergent purpose insurance as well.

My wife has started seeing a new therapist who she seems to really like. The therapist is out of network for our insurance (Cigna) and I think does only self-pay, but issues a superbill at the end of the month that we can submit for reimbursement. This superbill contains her NPI number but not her TIN. I have submitted claims with these superbills to Cigna but they have been denied due to lacking a TIN. After seeing the denials I googled and found that this provider is a sole proprietor therefore her TIN is actually her SSN, and that it is a relatively common practice for solo therapists to be structured this way instead of through an LLC. If she declines to provide a TIN to our insurance company is our only recourse finding a different provider? I’m not going to ask my wife to switch but just want to understand the lay of the land.

I live and work in California for reference. I left my job to seek treatment for substance use disorder and Kaiser is claiming that they cannot excuse me since I did not participate in their outpatient program. I met with a doctor every week and he prescribed me medication to detox at home from fentanyl and methamphetamine. However they claim that this is not considered to be under a doctor's care and will not sign documentation for those dates. Over the course of 28 days I detoxed three times and relapsed three times before they sent me to a third party inpatient program. I am new to the Kaiser program as of this year and they recommended I go through their detox at home and outpatient program instead of directly to inpatient in spite of my long history of substance abuse and my multiple stays at detox facilities and residential facilities. Currently I am unprotected for these 28 days but I am wondering if this is legal?