Hey all, I'm looking for advice on an issue that's been bugging me. I went to the orthodontist office regarding wisdom teeth extraction (in network). They already charged me a $200 consultation fee (This, I know isn't covered by my insurance). They told me my insurance isn't covered and that I can pay upfront and they can send a claim to my insurance and if it's covered they'll reimburse me. So I paid upfront, did my surgery and healed. 12 days later, I called my insurance for a follow up and I found out that there was no claim filed. And in fact my insurance DOES cover the extraction and bone graft. Im only supposed to pay 20% while insurance covers 80%. So we called the orthodontist office and told them they need to file a claim because they're in network. The front clerk basically said she'd relay the message to the billing team. Few days later, no claim was made yet. Best believe I called every single day until the matter was fixed. So finally I see a claim that they've made after 2 weeks of constant back and forth. Take in mind, I paid $5,356 out of pocket. My charges were $5,000 for TWO bone graft. $268 for the extractions and $88 for the anesthesia l'm assuming because it says "Ir". They filed a claim for $5,000, I immediately called my insurance to find out what they filed for. Apparently they filed for a completely different treatment than what l've done. And guess what? Whatever they filed for isn't even covered by my insurance. I definitely feel like this office is trying to rob me and get away their fraudulent behaviors. I spoke with the oral surgery department from my insurance and he called them today, confirmed my treatment with them and told them they need to submit a new claim for the correct treatment. Insurance told me to give it a week, if nothing is done, call them back and file a formal complaint. Will this do anything? I'm anxious and I just want my money back. I learned my lesson 100% and will NEVER pay upfront for something that should be covered by my insurance.

I feel like this rate is insane for me being by myself 21 year old male in a brand new $50k plus Cadillac, I do need the snapshot through progressive (absolutely hate that) but I have been told my policy is half what it should be anywhere else. Clean record but why is my policy so low? I have average deductibles and had a third party review my account and said the coverage is right where it should be.

I posted a couple of weeks ago about an ongoing claim between the hospital where I had ACDF surgery at on November 1st and my health insurance, UHC. The latest development is that UHC has sent yet another claim letter to the hospital , asking for specifics on an unidentifiable CPT code. Based on a prior claim letter, I suspect its CPT code J8499 which was sent to UHC to the tune of almost $14,000 out of a nearly $30K claim. I had read that this code is used for oral drugs but I can’t imagine what they would have given me that would have cost that much. The claim is on hold for 90 days yet again, but I’m getting spooked just like I did a couple of weeks ago. I mean, this claim has just dragged and dragged because UHC has to keep asking the hospital for information and I just don’t get what’s so hard in terms of the hospital giving them what they need. Anyone familiar with the code and its use?

I adopted a dog last March. I signed up with Spot for regular and preventative. Last year in May I got his teeth cleaned and they covered $150 of the cleaning, great. The new calendar year is here and I assumed like my health insurance the clock would start again at the beginning of the year. Nope. They go by the calendar year from when you started your plan so they denied my claim. Not a huge deal but if you are covered by Spot know that their preventative coverage is based on a year starting when you signed up for your policy.

Hi All, I’m here to both give a review and also ask a question. I’ve had lemonade insurance (wellness + accidental coverage) for about a year & 5 months now. At first, I really enjoyed it and didn’t have any issues with them, now I wouldn’t recommend if you have a pet that is known to get into incidents. I adopted my dog from a previous family who conveniently excluded his PICA issue. He is a 3 year old cavapoo who is notorious for taking anything he can get his hands on (socks, underwear, hygienic products, etc) and swallowing it. He’s had 2 surgeries (1 in March of 2024, and another in June of 2024). His first surgery was pre-policy and he was not insured with Lemonade. His second one I did receive reimbursement. We recently just went through another scare now in July 2025 (we have a behavior consult soon and take serious precautions, he is just VERY VERY sneaky) but thankfully, he was only hospitalized with fluids and passed the clothing in his stool, NO surgery was performed. Now, Lemonade is denying my claim to cover the costs of hospitalization due to “Foreign material ingestion being determined to be a Recurring Condition, which is not covered under this policy.” I reread my policy, and this is the exact language on it: “Conditions arising from a repetitive and specific activity that leads to decontamination (i.e., the induction of vomiting, stomach pumping, or treatment with charcoal), medical, or surgical treatment of your pet, if the same or a similar activity occurred two times within 18 months prior to the treatment date.” I’d like to add the claims specialist also got his medical records incorrect in her summary and argued that the decision was also based on the surgery that happened in March BEFORE my coverage took place. I got her on the phone and corrected her inaccuracies, but she is saying based on the recurrent conditions definition, those 2 incidents (March 2024 and June 2024) fall under the “18 months prior to treatment date.” From my understanding and the actual explicit language of the policy, how can the March 2024 surgery be considered if it predates coverage and there’s no legal language stating that pre-policy incidents are included?? Am I crazy or should I escalate this with DFS??, I am in NYC. Any lawyers’ thoughts welcomed!!

I am in the habit of constantly asking clarifying questions and I ask the same ones over and over again to different people (I call frequently) and I get different answers all the time. I never truly know what's covered or how much it's going to cost. It's so much BS. The medical facilities give me more accurate information than Priority Health does. 3 Priority Health people have told me my son receives unlimited therapy visits because of his diagnosis, but I know that's not true, and I've had only 2 people tell me the correct number of visits he gets for his diagnosis. The pediatric office even knew the correct answer. How is this legal for them to be so wrong all the time? Ughhhhh

I got a BMW from Auto Trader in October. The garage I got it from was dodgy as fuck but the car seemed fine. After 3 weeks oil all over my drive way, since then been in and out with constant problems. (Engine coolant system failure, new control module, new turbo with new gaskets and turbo actuator). I took the car to my regular garage since the one I got it from was dodgy (I understand now this was a mistake), I phoned the original garage and since I never took it in to them they’re saying there’s nothing they will do. Since Christmas I’ve had the car for 13 days, have it a couple days then in the garage it goes, constant problems. None of this is my fault, the garage has confirmed this, I know how to look after a car. £4,000 roughly in garage costs. Plus the money i’ve been spending on finance etc on a car I do not have. Can anyone please give advice on anything I can do to be reimbursed on some of the money I’ve spend since none of this is my fault and the car is so recently in my possession. I have been in touch with finance company (Carmoola) just waiting for the final receipts from garage to forward them.

My pet insure Nationwide discontinued our pet policy. My dog a 4 year old Labrador has preexisting allergies. Trying to find the best pet insurance. Any ideas? Our vet does not use Pet Assure. Update: Nationwide reinstated my policy but only at 50%. I will take it since my dog has allergies.

I got involved with them on my 18th birthday, which was in November. I left at the end of December and told them I was moving to Houston. I got the life insurance policy when I joined since it was required, and I canceled it yesterday. Today, I got a call from the agent who recruited me. I told him I couldn't talk, but he said the contract required me to keep the life insurance policy for 17 months. I hung up, blocked him, and called my cousin since he also joined at the beginning of 2024 (recruited by the same person) and left shortly after. He canceled his policy as well. I told him about the call, and he said the agent called him too when he canceled his policy, telling him the same thing. He told the agent he didn't want it, and the agent said he would be sent to collections or something like that. I don't know if that's true but I don't know what to do.

Wife got into an accident. She was stationary at an intersection. Other car turned into her. Our car 2013 Elantra suffered a cracked bumperl We took it to Maaco ..they estimated 2115 or so. Progressive accepted responsibility. Like a fool i verbally told them I would accept cash settlement, They sent me their estimate which was $915..yikes....havent received check yet.....do I have any recourse?