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. \[There are numerous prescriptions that Priority Insurance refuses to cover, but Anthem will. It seems like having to use both insurances could be a double-edged sword. The primary reason I have two private insurances is to mitigate the issues with prescription plan exclusions. Specifically, one insurance company will cover certain medications that the other will not, and vice versa.\]

I was following up with Humana dental for a denial of a filling of $482 The filling was on a tooth that had a partial crown that fell off and had to be recemented. Their policy now is if you have a tooth with any type of crown; full, partial, or onlay, no matter how old, they will not cover a filling in the same tooth.

We recently rescued a mastiff puppy. She came down with parvo but is on the road to recovery. I would like to get insurance for her but I am concerned that having parvo as a puppy is a recipe for getting denied for any claim going forward. It just seems like parvo is one of those illnesses that could count against anything that goes wrong in the future. I reached out to Lemonade and their response was very general and generic. Preexisting, reviewing history with any claim, etc, etc.

So the story goes: My friend in Texas totaled his car by hitting a mailbox. He has Gap insurance from the dealership, and auto insurance from progressive. Auto insurance agent told him they're going to pay the dealership instead of him. Can friend demand direct payment to himself, as the policyholder? Can his insurance just send the check somewhere else like that? The gap insurance should handle everything on the dealership side, so I don't know why his insurance company would be giving the dealership anything.

I had a home claim, and State Farm issued a check made out to me, my mortgage company, and the down payment assistance program I used. I had both parties endorse the check (which was already kind of tedious process that took 2 weeks) and now US Bank says they won’t accept the mobile deposit because the payee doesn’t match the name on my account. I called customer service to explain, and they said US Bank won’t accept deposits unless the account names match. I did call after regular hours so maybe it’s an overnight service that has bad info. But surely 1) this isn’t a particularly unique situation and someone at US Bank has to know what the protocol 2) the standard here can’t be that I have to open up a bank account with both the down payment assistance program and my mortgage holder, can it? I feel insane that I can’t find any info about this online, so I’m hoping that means there is a way. ETA: Ended up having to mail it to a branch! But for future readers, no, you are not expected to set up an account with you and your mortgage lender, thank goodness!

Evacore under the auspices of Highmark ( aka Gravemark) has denied my cardiac cath for the second time. Next step —- letter +\~ phone call to Evacore ????

My neighbor scraped my car in our shared apartment garage. I park right next to her every day, and the scratch on my vehicle lines up perfectly with damage on hers. To top it off, her paint color is visibly transferred onto my car and vice versa.. She’s claiming she didn’t do it, but I’ve already filed a claim with her insurance and an adjuster has reached out. The adjuster says they’re still trying to determine liability since my neighbor is denying everything. Here’s where I’m stuck: -Should I keep working with her insurance and try to prove it to the adjuster directly? -Or should I go through my own insurance (which would mean paying a deductible upfront) and let them fight it out behind the scenes? I’d prefer to avoid paying anything out of pocket, but I also don’t want to risk her insurer denying the whole thing and leaving me with the bill. Any insight from people who’ve been through this or know the industry would be really appreciated. Thanks in advance!

Has anyone that has Nationwide (I know, I hate them for dropping so many clients and if my animals didn’t have so many conditions that would be considered “pre-existing” and not get covered elsewhere, we’d switch in a heartbeat) been experiencing issues with the website saying that the session has timed out almost immediately upon logging in? It’s been going on for me for MONTHS now and so submitting claims online is an absolute PAIN because it keeps logging me out.

I have Wishbone pet insurance, and they are very slow to response for either. Everyone has been very nice, but my claim just got denied for 6 months after my dog ruptured her CCL. What is frustrating is she had the zoomies on 5/3/2025 and that is when she tore her CCL. My waiting period is 5/9/2025. Am I just out of luck and 5 days is the difference between 3k out of pocket?

I have a long winded question. I want to preface this by saying I am not into fraud. I am a public employee and can’t have any issues related to that. 3 years ago we had a bad hail storm in the Chicago area. We have a close friend who is an adjuster for a roofing company. We coach our kids together and he tells me “hey do you want a new roof?” He tells me everyone is getting approved after the bad hail storm. I have zero experience with this so I said “of course.” I figured that’s why I pay insurance and this guy said it so non-chalantly so I agreed to it. He comes over, looks at the roof and submits a claim. A week or two later he tells me that our insurance denied a new roof and only said they would cover $1,000 in repairs. In my mind it’s a win since we get repairs done. Fast forward a year later and we have another hail storm. Our friend says to me “this time you will definitely get a new roof.” Again, we have no idea this is an issue. He looks at our roof and submits a claim. A week later we get a call from our agent and they tell us they are likely going to drop us. This is where my wife and I panic and wonder “what the hell is going on?” We get the insurance to stop the claim and somehow they do stop it and we don’t get dropped and don’t get the repairs done. So far no issues but still we are very worried about it. Since then we have had a few roofing companies out and the prices are crazy. Like 12k just to repair and 25k to replace the whole roof. My question is this: Would you recommend that we replace the roof on our dime? We have the money to do it. This is what I’m leaning towards but what happens if we have a really bad storm with significant damage? Does State Farm drop us but still have to pay for the damages or replacement? I don’t want to replace the roof, have significant damage, and then State Farm says nope you’re dropped and we aren’t paying? OR, should I switch insurance companies before any work and then replace my roof anyway to lower the premium cost with a new insurance company? Insurance prices are ridiculous right now but state farm is still lower than any other insurance company I have had quotes from. Thank you for any advice you can provide. Edit: I agree with all the comments that the guy screwed me. I am aware that the claims follow me. I need to find an honest person who can tell me if I really need a roof replacement. If not, I’m willing to ride it out until I do actually need a replacement. The thought of doing it now came because in 5 years we will have 2 in college and one in high school. We figured we would take the expense now rather than in a few years when money is a bit tighter. Still unsure of what we will do. I don’t think I need a new roof immediately but I know it will be in the next 5-10 years.