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BCBS OF MI 40.72
GEICO - Car accident of three cars.
My father was heading home 5 minutes away from home actually. When I got a call from him saying that he had been in an accident. Since it was five minutes away, I rushed over there. When I arrived, a nice lady approached me while I was recording saying that it wasn’t my fathers fault and that the other two cars involved, a Charger and a Camry were racing, speeding down the street while swerving in and out of lanes. I spoke to another witness who blamed the Charger for going 80 mph in a 40 mile zone and said that the Charger caused the accident because he collided with the other Camry. All I know is that my father got hit, the driver of the Camry was taken to the hospital. Now, my father being the nervous man that he is told the officer that he was already turning left into the resident street. My father speaks very little English. Well the officer automatically blamed my father saying that the speed of the other cars didn’t matter because they had the right of way. Well when my father came home he clarified to me that he meant he was waiting in the yellow lane waiting to turn left into the resident street when suddenly the Camry and Charger were racing down the street. My father explained that the Charger hit the Camry on the side which led the Camry to lose control and hit my father head on. I gave the officer the witnesses numbers. The witnesses indeed said that the other two cars were speeding and yet he didn’t give them tickets so that’s a bummer. Now the Camry got a lawyer against my policy. Essentially everyone got claims against each other. Now, GEICO, the Camrys insurer sent a letter to my father stating that they would not be able to pay for his work truck because their investigation concludes that the Charger was at fault for not having proper lookout. I need advice on what to do. Does this mean that the Charger will be paying my father? Does this mean that since GEICO is saying that the Charger is at fault then the Camry should drop the suit against my insurance company? What do I do!!!! Please help.
Trupanion - Is Trupanion’s claim calculation method kind of... off?
I recently submitted a claim to Trupanion and it seems kind of weird.
For example, let's say I claimed for $1000. The deductible is $200 and a 90% coverage rate, which means I pay 10% coinsurance.
So based on that, I thought the math would work like this:
* $1000 - $200 (deductible) = $800
* 90% of $800 = $720 → Trupanion pays
* 10% of $800 = $80 → I pay (coinsurance)
But instead, here’s how they seem to calculate it:
* 10% of $1000 = $100 → My coinsurance
* $1000 - $100 - $200(deductible) = $700 → Trupanion’s portion
This feels off to me — like they’re applying the coinsurance *before* the deductible, which doesn’t seem logical. Shouldn’t the deductible come off first, and *then* they apply the 90% coverage to the remaining amount?
Has anyone else experienced this with Trupanion? Am I misunderstanding how their calculation is supposed to work? Is all other pet insurance company calculate the claim in this way?
Corebridge - Claim processing time
My dad (57M) died by suicide in September. He had an adjustable life policy with Corebridge (formerly AIG) since 1986, so well beyond the exclusion period.
We had trouble getting the death certificate and ending up filing the claim in December. We didn’t have access to his policy documents but we found out my mother (dad’s ex-wife) was the primary beneficiary. With my sister and I (his adult children) being the contingent beneficiaries.
Due to revocation upon divorce laws, my mother will more than likely be denied the claim. Their divorce decree does not make note of life insurance, my dad simply just didn’t change it after 14 years of divorce. Corebridge advised she file the claim anyway and wait. Well, the claim was filed in December, all paperwork sent in on December 9th. I figured it would take some time with the holidays and all but it’s been just about 3 months. I’ve called several times with them just claiming it’s still under review. Corebridge said claims normally process within 7-10 business days but they have no update as to what is the hold up.
Is this pretty standard? Also, should I wait to see the outcome of my mom’s claim? Or should I just go ahead and file my claim? Any feedback is greatly appreciated!
Empower - New Employer 401k Options
I just started a new job and received the Empower 401k fund options below. All of these funds appear to have high expense ratios (most around 1%) and overall don’t seem to be that great.
I’m considering rolling over my old 401k to this new plan or an IRA. My old plan is valued at approximately $500k invested in passive total market index funds. I’m 40 married no kids.
While I won’t be able to do the backdoor Roth IRA if I rollover my old plan to an IRA, I feel like the funds available at fidelity are superior to these.
I’m just looking for another opinion on this before I make any decision.
Thank you!
American Century One Choice In Ret ARTAX - 1.01%
American Century One Choice 2025 ARWAX - 1.03%
American Century One Choice 2030 ARCMX
American Century One Choice 2035 ARYAX
American Century One Choice 2040 ARDMX
American Century One Choice 2045 AROAX
American Century One Choice 2050 ARFMX
American Century One Choice 2055 AREMX - 1.14%
Virtus NFJ International Value AFJAX - 1.3%
American Funds EuroPacific Gr R3 RERCX - 1.12%
Invesco Balanced-Risk Alle R5 ABRIX - 1.08%
Invesco Developing Markets Y ODVYX
MassMutual Global Svc. MGFYX - 1.13%
Invesco Real Estate Y IARYX - 1%
MFS Utilities R3 MMUHX - 1.02%
PIMCO Commodity Real Ret Strat PCRAX2 - 1.45%
Columbia Small Cap Index NMSAX - .45%
Franklin Small Cap Value Fund FRVLX - .97%
Invesco Discovery ODIYX - .79%
MassMutual Mid Cap Growth Service.. MEFYX - .86%
Virtus Ceredex Mid-Cap Value Equity I SMVTX - 1.02%
BlackRock Equity Dividend MSDVX - .97%
MassMutual Blue Chip Growth Service.MBCYX - .85%
MM S&P 500 Index Adm MIEYX - .49%
Loomis Sayles Strategic Income Fund Y NEZYX - .67%
MFS Government Securities R3 MFGHX - .76%
Invesco International Bond OIBYX - 79%
Infl-Prot and Inc (MassMutual) MIPYX - .69%
Capital Preservation Account CGPJQ0
Blue Shield of California - Kaiser HMO vs Blue Shield PPO
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.
EMI Health - Being Billed for Dental Visit - Was not informed of work being done
Hi,
First off, let me list out my situation quickly:
Washington State
College Student
Insurance: Medicare --> EMI Health (Switched, received pay raise)
Today, I checked into my dentist for a cleaning. I informed the front desk person I had switched insurance providers. She didn't say much, but checked me and said I would meet with a patient resource person after my appointment.
I went back, had what I thought was just a cleaning. I went to the waiting room, then had my meeting with the patient resource specialist who told me that my insurance was no covered. no worries, what does a cleaning cost? $70? No issue. Well no. They did a "scaling" thing because my gums were inflamed so the total is $209. In this meeting was the first time I was informed about the scaling they did to my teeth. I have no recollection at previous appointments of them mentioning scaling or anything. I was never disclosed any cost because if I would have heard $209, I would have dipped quick.
Is there anyway I can get out of this? I feel kinda screwed over because I had no idea what they were going to do to my teeth or procedures performed. It was my impression it was just a cleaning. I understand it is MY RESPONSIBILITY to verify my dentist is in my network, so I own up to that. It is mainly the scaling thing...
I have a phone call with the dental supervisor. What should I say? I want to be as respectful as possible.
Thanks
FIGO - FIGO Costco pet insurance
FIGO Costco pet insurance. I’ve been paying $133 a month for a healthy dog. They literally only pay $50 a year toward vaccinations. I went ahead and cancelled. I just can’t justify such poor assistance for these expensive vaccinations. His vaccinations and annual checkup is $300. I am considering setting up a savings account dedicated for my dog. I should have read the fine print.
Anthem Blue Cross Blue Shield - hospital is charging me 17000$-and no one really knows why
i visited the ED back in march 2024 and ended up being placed in observation and let go the next day.
i’ve been dealing with an insurance/billing issue since then. i have anthem BCBS under an employee sponsored health plan (Union Construction Workers). the hospital i visited was In Network. for some reason, the hospital is billing me around 17000$, stating that my claim was denied due to code *00897, which requests complete medical history from the member.
the member being myself, so i contact my employer sponsored health plan claims specialist, and she has no idea “why they would want that [referring to medical history]” and ensures me the claim is covered and sends over the EOB. which states patient responsibility is $1500, and not $17000. she lets me know that UCW paid mercy back in july.
anyway, fast forward to november i am getting billed $17000 again. i call billing, they escalate my case, and remove the $17000 charge from my statement. i call UCW again, and they let me know the claim has been paid. billing is telling me anthem denied the claim again. they ask me to resend the EOB.
fast forward to now, i am getting billed 17000$ AGAIN! i call billing, they tell me that the anthem claim is denied. i ask them if they looked at the EOB. they say yes, i ask them if we can go through the EOB together. we look through my UCW EOB and the billing employee states that my ANTHEM EOB was reviewed and for some reason my UCW EOB was not reviewed but it was received after i sent it in November. he agrees, i should only owe $1500 per the UCW EOB. but anthem is denying my claim still.
i call UCW again. the rep tells me that she is now contacting anthem directly. after 9 months of issues we are finally contacting anthem. and there is no way for myself to contact anthem, only through the UCW representative.
i am giving birth in about a month, im in a rush to get this handled. i would accept any help that i can.
i have looked through the itemized bill, UCW EOB, and claim on anthems website and reviewed for errors. i noticed that there is one charge (for $9.50) that insurance covered that is listen on both the itemized bill and anthems claim, however not listed at all on the UCW EOB.
but i, a not insurance expert, does not know what this means.
please please help if you can! i have already talked to my states insurance department, which they were confused w my situation and could not help. i also have requested proof of payment from UCW, as well as a 3 way phone call between UCW, myself, and billing.
American Family - Overhead&Profit Dilemma
For context, this is in reference to a claim with American Family homeowners policy in AZ.
Long story short, we had a claim for our shower 6 months ago. Contractor gave estimate for $8700 (ish) and I was paid $7700 (ish). Our responsibility is our $1000 deductible. Our contractor is auditing our account to make sure our final bill is correct and he’s saying that O&P was only included on a few line items and not all of the line items. He thinks we are owed more money because it wasn’t properly calculated. The adjuster is saying that O&P is only paid when 3 or more trades are used and we had more than 3, but somehow there is a disconnect and the adjuster is stonewalling him. I don’t know how to approach this situation. We’ve used this contractor before on a previous claim years prior so I trust him and his expertise about insurance claims and what’s “right” and not fraud. And if this is how he deals with other claims, how is it that American family is causing such a headache? I just don’t know what to do. He also thinks that if he was dealing with an experienced adjuster this wouldn’t even have been a discussion and it would have been handled correctly. Any insight would be great. Thank you.
Pets Best - Pets Best - Incidental Finding during Waiting Period
Hi everyone!
We went with Pets Best for our kittens’ insurance, which starts for illness coverage on 8/21/25. Pre-anesthetic bloodwork was done last week in preparation for one of our kittens’ neuter scheduled on the 18th. The results came back a bit all over the place, which the vet wasn’t concerned by as he said it could be due to him being so young. However, the vet mentioned his T4 is elevated, which could suggest juvenile hyperthyroidism. We’ll need to retest in six months to see if it normalizes.
My question is: since this was found before the waiting period for illness coverage ended, and there are no symptoms, no official diagnosis, and no specific treatment or medical advice given yet, do you think Pets Best will consider this a pre-existing condition? A bit stressed that if it does come back as high in 6 months, something that seems like it may be a very expensive lifelong condition is going to be automatically excluded due to an incidental finding 😅
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