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Insurance companies are constantly reviewing us. Are we too old? Do we live in the wrong place? Is our credit score high enough? Well, now it's time to turn the tables. Do you charge too much? Will you pay my claim quickly? Is your coverage worse than it seems? We can review you too.
State Farm - State farm policy change price?
I am getting a new car delivered to me friday and trading my old one in, I went to update my insurance policy through state farm & it’s showing my total change cost to be $733 just to remove my old car & add the new one. Is this normal? That seems insanely high
Blue Cross Blue Shield - "All inclusive" copays
I'm going to keep this as short and to the point as possible..
Before my job forced us to change insurances, my BCBS plan had an all inclusive copay, meaning when I visited my specialist(or anyone for that matter), I paid $70. That was it. I had been getting bimonthly infusions that cost just under $10,000. All covered under the $70 copay. Rad.
When we were forced to switch, we had our choice of hundreds of plans. I tried SO DAMN HARD to get insurance plans to tell me what my infusions would cost under their specific plans and got stonewalled every step of the way. I had all of my billing codes and everything. Long story short, I ended up choosing one that I believed had a similar setup to my last plan: all inclusive copay. Turns out, it is, but they are trying to bill me for the prescription used during the procedure($9,000+). I have to pay for that($300 specialty tier med) AND the copay. They couldn't explain why that is a loophole.
My infusion is a buy and bill, which means it is billed under MEDICAL, not prescription benefits. What am I missing here??
TLDR: "All inclusive copays" have loopholes apparently?
my ins co - In which states are balance billing waivers illegal?
I reported a provider to my ins co for balance billing. The provider wanted me to sign a waiver allowing them to balance bill me. I asked the rep if this waiver is illegal, and/or would it get the provider kicked off for violating their contract. I really couldn't get a straight answer. I was just told that unfortunately a lot of providers do this, and there's no guarantee of what will happen to them.
Is it worth it to also report them to my state's insurance division? I don't want to waste my time if these balance billing waivers are legal.
Lemonade - Cancelling Lemonade and renewing with additional coverage
Hi everyone,
I have a 9 month old maltipoo. I suspect he has chronic GERD since he throws up yellow bile if he goes around 6-8 hours without a full meal (like overnight or when he is stubborn and wont eat his lunch).
This is to say I want to take him to the vet asap. But before that I wanted to add dental coverage to his policy just in case this issue persists and it causes teeth problems later in his life and then they wont cover it because it was a “pre-existing condition.” Dental work on dogs is very expensive!
My problem now is that I emailed asking how I can go about adding this to my policy since I couldn’t find how to do so on their app. This is the response I got. i don’t understand why I can’t ADD coverage. I want to pay MORE money. I wasn’t aware that when I bought the insurance for the year it was locking the policy for that entire year.
Now I’m thinking of cancelling all together and renewing with the actual coverage that I wanted. Has anyone tried doing that? Would they let me? Or would they recognize my name and vets and ban me or something.
Thank you for all the help
TLDR; has anyone been able to cancel their Lemonade pet insurance and renew with the actual coverage/policy they wanted?
Odie - Odie: How Long Should Direct Deposit Take?
I filed three claims with Odie over a month ago. Thankfully, they were all approved. I requested direct deposit for reimbursement. This was on Monday. Today is Friday and I haven't received anything. ManyPets used to pay with 24-48 hours after approval. Anyone have any experience with Odie? How long does it take them to reimburse?
Healthy Paws - Further Update on Healthy Paws Premium Increases (Info from Dept of Insurance)
Here it is, the Healthy Paws rate filing so you do not need to struggle to find it.
HP requested a 44.8% increase... and got it approved. (Remember, the last several years already had similar increases).
Still doesn't answer how I got a 180% increase, so sit tight...
Taking my case aside, let it sink in:
They asked for, and got, a 44.8% increase.
Vet costs, even in CA, went up that much in a year huh?
So remember when they spit out the canned response online of:
*In accordance with the terms of the Policy and the associated rating rules, monthly premiums may change for all policyholders. Premiums are determined based on the rates and rating rules filed with and approved by (where required) each states insurance regulator. Premiums reflect the cost of treatment advances in veterinary medicine, characteristics of the individual pet, and other factors, in addition to the overall claims experience for the program within the region where the pet resides. Please note that premiums are not based on a given pets individual claim history; rather, premiums are based on the collective experience of all pets insured. We do our best to be transparent regarding annual premium increases by including this information on the "Frequently Asked Questions" page of our website. The Healthy Paws Team*
remember:
1) THEY.ASKED.FOR.THESE.INCREASES. They then use this corporate jargon to say it went up in accordance with the rate filing (WHICH.THEY.ASKED.FOR).
2) The "transparency" is not transparent. Look how much digging one had to do to find the above screenshot, when all their FAQs again say:
Will my premiums increase?
In accordance with the terms of the Pet Health Insurance Policy and the associated rating rules, monthly premiums may change for all policyholders. Premiums are determined based on the rates and rating rules filed with and approved by (as applicable), each state's insurance regulator, which reflect the cost of treatment advances in veterinary medicine, individual pet's breed, gender, age, and other factors, in addition to the overall claims experience for the program within the region where the pet resides. Premium increases are not based on your individual claim submissions.
insurance company Y - accident covered by non-insurance company?
Two weeks ago, I got rear-ended by a commercial truck owned by a logistics company, X.
I originally filed the claim through their insurance company, Y (as listed on the driver information exchange).
A few days later, insurance company Y told me that company X would cover the accident and gave me a claim number with X.
I can only get in touch with X by email (which has very slow correspondence), and their phone line is always busy. After I sent them all the information they requested, the only response I got was that they are "reviewing" the case and will discuss it after that—without mentioning how long it will take. Since they are not an insurance company, I assume they don’t handle claims in the standard way.
Now it's been more than two weeks, and I still have no idea how they plan to address this.
Are there any legal requirements for how soon they need to respond and resolve the issue? (I do not want to go through my own insurance and pay out of pocket.)
What actions can I take to push them to make progress on this?
Any suggestions or advice would be greatly appreciated!!!!
United Healthcare - Procedure happened without authorization?? Need advice
UPDATE: I called this morning and apparently the post authorization did get approved without my knowing and without updating in my online portal. It's still showing online that I owe the full amount but the employee I spoke with said to ignore those charges and wait for a bill in the corrected amount of $333.87 which is much more palatable. Major thank you for everyone's input!! It was late and I was getting very anxious about it, I seriously appreciate everyone's comments. Hopefully there won't be any more mishaps and I know better moving forward to make sure preauth gets sent.
Recently I had a colonoscopy at the suggestion/request of a gastroenterologist for issues I've been having. This was my first time having any kind of outpatient procedure and my first time dealing with marketplace health insurance (United Healthcare) on my own.
I did not know that prior authorization was a requirement for this procedure. Prior to scheduling the procedure I spoke with UHC about coverage and was told I'd only be charged the copay because it was in network. After the procedure I found out the medical office and hospital failed to request authorization and did the procedure anyway, now I'm being charged $5,000+ for the colonoscopy because of it.
I didn't know I needed authorization and moreover it was the medical facility's responsibility to get that, and NOT perform the procedure unless it was granted. Am I mistaken? Has this happened to anyone else? What are my options? I've already called the medical facility to submit a post-authorization appeal but it seems to be denied as well. I'm at a loss and feel entirely screwed over, would love some advice!
Liberty Mutual - Insurer offering ~10% of repair cost
This is my first rodeo with homeowner’s insurance (Liberty Mutual) and it’s a nightmare. Looking for advice on how to proceed. The backstory is that a local company installed a new appliance in my home and bungled it. Their mistake caused some water damage to my kitchen and major damage in the finished room directly below. The appliance company gave information for their insurer, but when the initial water remediation was done and uncovered the extent of the damage, I filed a homeowner’s insurance claim instead and figured they would subrogate.
I currently have a wall in my kitchen down to the studs with some cabinet boxes, trim, and the dishwasher removed and sitting in my sunroom. The counter is being held up by a piece of scrap wood. There are some minor signs of gapping in the hardwood floor that is usually hidden from view, so I’m hoping to let it ride. Meanwhile the room beneath the kitchen is uninhabitable. One wall is down to the studs with no insulation (exterior wall), LVP flooring removed, and holes in the ceiling from water remediation equipment. I received a repair estimate from a local contractor for $25k (HCOL area, home value approaching $1mil). This includes insulation, sheet rock, plaster, paint, baseboards and trim, ceiling repair, LVP flooring downstairs to replace what was there, reinstall of existing cabinet boxes, and plumbing. It does not include new cabinets or counters.
My claim with Liberty has been in process for 8 weeks and a field adjuster came out 2 weeks ago with radio silence since then. The contractor has also been contacting Liberty for updates. Liberty called today and said the field adjuster calculated $700 to repair the kitchen and $2300 to repair downstairs for a total of $3k. I understand it’s an initial offer and figured I won’t come out of this without burning cash of my own, but it doesn’t cover the cost of materials let alone labor. And there’s not even a guarantee that my custom cabinets and counters will come out the other side looking the same.
What do I do from here? Do I eat $20k up front and turn around and sue the appliance company to be made whole? I thought that was why I had homeowner’s insurance but this is a real nightmare. And to top it off I’ll be adding a newborn to the mix in less than 8 weeks with my house in shambles and no dishwasher (first world problems, I know).
Healthy Paws - Electrochemotherapy and Pet Insurance Coverage
Hello can anyone share if their pet insurance covered electrochemotherapy for their pet? I have healthy paws and inquired and they said it “may be covered” subject to policy rules. However electrochemotherapy is not FDA-approved in the United States and healthy paws policy states they don’t cover non FDA-approved treatments. Just looking for some insight. Thanks.
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