Hello! I have Guardian Dental insurance. I just received a bill where I am responsible for $217 - Guardian only paid $47.00. Services billed were D0120 and D4910 (Periodic Eval and Periodontal Maintenance). I went on my Guardian account and it says that both codes are covered 100%. They are both under preventative and the coinsurance is listed as 100%. "Detailed and extensive oral evaluation (D0160) is not covered. **Oral evaluations, including codes** ***D0120***\*\*, D0145, D0150, D0170, D0180 or D9430, are covered once in any 6 consecutive month period.\*\* The limited oral evaluation - problem focused (D0140) is not included in the frequency limitation or last visit date." "Periodontal maintenance (D4910) is covered under the Basic service category. Adult prophylaxis (D1110) is covered age 12 and over. Prophylaxis (cleaning) (D1110, D1120) or **periodontal maintenance (D4910) is covered once in any 6 consecutive month period."** My date of service was 3/6/25. I have not had any other services in the last six months. My last visit was 9/3/2024. My deductible is $50, "Yes" means waived for preventative. To date, I met the $50 deductible and Remaining is "0". || || |Individual Dental|Out of network|$50.00|Yes|$50.00|0| ||In network|$50.00|Yes|$50.00|0| My deductible is $50 and it says I paid it... and my coinsurance is 100%? So even for preventative services, this means I'm responsible in paying all of my dental care beyond the first $50? My yearly plan limit is $1000. What is even the point of having health insurance? Is this because I got basic coverage instead of full coverage? I guess I'm ignorant and thought that preventive care would be covered. I feel really stupid right now! I tried calling, but they aren't open. Any assistance to help me understand is appreciated.

Hi we have progressive as for our auto insurance we had an accident and it raised from $2000 to $4000+ for our premium and we added 2 more cars didnt really save us money like that. We pay almost $800 monthly for 3 cars. I just got licensed in CA so i dont have a driving record yet. (I was from another country) I was trying to get a policy under my name. I dont think I can since theres not much driving history. My husband has a dui from 9 years ago and we cant get geico. Were running out of cheaper options. What can we do or has anybody had this issue and what did you do? Where can I shop around for auto insurance.

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?

Spoke with a woman who would not directly answer any of my questions. I asked how long until they cover a CURABLE pre existing condition such as a UTI for a cat which is a common thing some cats deal with and she went on and on and on about broken bones and all this other nonsense. I tried to steer her back to the original question several times and she just couldn’t stay on topic. I don’t know if she was on something or what her deal was but it was very weird. She didn’t want to give me a direct answer. I finally asked to speak with a supervisor. She put me on hold for several minutes and came back and said no one was available. Then she message the supervisor with my question, the supervisor just answered it directly. Imagine that. I asked a question and they just answered it. I told her thank you and that was the question I was trying to get an answer to. She said I should have told her that lol. I tried to explain how this can be frustrating and a little suspicious to a pet parent that’s trying to get info. I explained that it is as if she was working me a little. Like she was saying words without answering the question and talking in circles. I would ask a question and she would answer it as if I asked another question. Very sales pitchy. It was very bizarre to say the least. She then started raising her voice and talking over me so at that point I told her to have a nice day. If you are also curious, there is no amount of time after a cat gets a uti that that they will cover it. There is no curable condition time period like some companies (usually 12 months to 18 months). My cat has had one uti a year and a half ago (she is 2 years old) and if she were to get one at any point in the future it will not be covered. The woman told me not to worry about a uti and that it’s not a big deal which made me uncomfortable. I had to give her a break down of how expensive it actually is. There is the office visit, which is often a same day emergency visit which is more expensive because a uti can come on quickly, the urinalysis, and the medications. It’s expensive. Hundreds of dollars. She then asked why I’m so concerned about a uti, maybe my cat has kidney disease or something. I said no, she does not, I would just like to know what I am paying for coverage wise, what is covered, and what to expect. She then began her sales pitch again and didn’t respond to what I said. She was off on another roll. Very unproductive and unprofessional conversation to say the least. When companies act like this and you get that pit in your stomach, it is bad deal and you need to get off it. There was nothing good about whatever that was. Really scary these people are in charge of providing insurance for beloved pets.

Seeking advice. I had an accident very recently where the other car hit my car while doing improper lane change. Even the police said by seeing the dash cam video of my car that the other person was at fault, I called my insurance company in order to report the accident but they filed it as a claim without confirming with me first. Even though I told them I don't want to use my collision coverage as the accident was not my fault, they still filed a claim without confirming with me first. The claim was closed next day without any pay as they suggested to contact the other person's insurance because I am not at fault. Now I am afraid that this claim will increase my insurance rate from now on, what should I do now? How much it might increase? Is there any way to remove it from the record? Any kind of suggestions will be appreciated.

So like the title says I had 2 doctor visit back to back days. One I saw the PA and the other I saw the NP. But the medical claim with my insurance says I saw the doctor. I received a bill from the clinic stating I owe an additional $76.93 for the PA and nothing additional for the NP. Both doctors are from same clinic but different specialties. I reached out to my insurance and they said it was both bill coded as me seeing the doctors. Is this correct? I reached out to the billing department of the clinic and it’s been almost 2 weeks and they haven’t gotten back to me yet. Is this correct? I paid $220.63 both times (I have a high deductible plan) I think. I don’t have a copay - I pay for everything my insurance doesn’t cover(which they don’t cover very much) If you have more questions to help answer this let me know. In the last month I’ve spent $1600 in medical and I want to make sure I’m being billed a surplus amount. Edit- I’m 29F from Texas and I’m insured through my job with UHC

I have medi-cal through anthem blue cross in association with LA care health plan. I have never had Medicare part B. I had a ultrasound in october 2024 which was approved by my primary care provider. I just got a letter today from the centers for medicare and Medicaid services, fargo ND. It is saying that the ultrasound was not approved and i may be billed 220$ It also says i have not met my part B deductible of 240$ Again, i don't have medicare part B. Im not experienced with these insurance issues. I dont know if medi-cal already paid this or not, it's been almost 6 months. Is this medicare preparing to bill me for services already paid by medi-cal ? Thank you, input appreciated.

I'm 41 and live in New Jersey. I work for a non-profit and make around $35k per year. A few months ago, I saw my GP for a regular check-up and mentioned that, in my job, people often speak confidentially, whisper, or are just low talkers, and I sometimes have trouble understanding them when it seems like there is an expectation that I should not, which can get frustrating. I said that I have not had my hearing tested since I was in grade school like 25 years ago and asked whether that's something that should be checked from time to time. She said sure and wrote me a referral to get a hearing test. So I went to the website for my insurance (Horizon, aka Blue Cross Blue Shield) to search for providers and easily found an audiology office that's tier-1 in my network a few blocks away. I called them, explained that I hadn't had my hearing checked in decades and was looking for a regular test with my doctor's referral, and gave them my insurance information so they could verify that they're in my network. I went for the test, which didn't really tell me much, and later I received the finalized claim notification and was surprised to see that I owe $1,041.85. I argued with the billing department, and then I argued with the insurance company. There are two different issues here, I've been told. First, insurance explained that the medical coding was for a diagnostic hearing test rather than a routine (annual) hearing test. (Obviously, no one ever gave me an option for which type of test I wanted to receive.) An insurance representative talked to the billing department while I was on the phone and was unable to convince them to change their coding; they insisted that they had coded it correctly and that it would be illegal to change it. Insurance doesn't consider it preventive care if it's a diagnostic test, even though their Preventive Health Guidelines document mentions "Doctor will ask about hearing difficulties and refer for further diagnosis" under "Other Recommended Screenings/Tests." When I escalated and spoke with a different insurance representative, she figured out the other issue, which became the main focus: I was billed as a hospital outpatient, not as a visitor to a specialist office. She was not able to change that by working with the billing department and filed an appeal internally with the insurance company on my behalf. About a month later, just the other day, I received a denial of the appeal in the mail. I can still file my own appeal, but I'm not sure how to get a different result. In the meantime, my "payment is overdue," and I'm worried about it going to collections and affecting my credit. The billing department isn't doing anything to hold the timeline even though I've told them repeatedly that I'm arguing with insurance about the bill and had them note it on my file. If I gave the audiology office my insurance up-front, didn't they have an obligation to inform me that the service wouldn't be covered? If I found the provider through my insurance website as in-network, didn't they have an obligation to inform me that the office was considered hospital outpatient and not a specialist practitioner? I should note that I live right by a hospital in a major healthcare city, and many of the facilities throughout the city are under their umbrella. My GP's office is also part of the hospital system. Their name is on the door. I use the same patient portal for my doctor visits as I got this bill through. So why, when my GP is a regular office visit, would this audiology office bill me as a hospital outpatient? I've had health insurance for almost 17 years through my job but only recently started exercising it at all. It's absolutely insane to me that I can be billed an amount like this without anyone letting me know up front that I'm agreeing to pay for a costly service rather than just a co-pay. I'm dealing with some dental stuff right now that's not covered by my plan, and the dentist's office has been extremely clear and forthcoming about costs months in advance. In contrast, this hearing test bill feels like a scam. Does anyone have any recommendations for what I can do from here? Also, does the No Surprises Act help me with this at all?

Brother moved to California on Thursday and immediately needed emergency services. Covered California's website says people can enroll within 60 days of moving here but the social worker at the hospital says he can't apply to medi-cal because he's not been a resident for 60 days. We've been getting conflicting information. I'm hoping I can find some help/clarification here. He's early 40s and has no income

I have a 5 year old maltese with no pre existing conditions and currently use Nationwide. My dog had to have a simple surgery to have something removed on her eyelid and Nationwide only paid out ~10% of the claim. I am looking to switch carriers in exchange for better coverage. If I only wanted to insure against accidents, unexpected events, and not routine care like vet visits and bloodwork, what pet insurance company offers the best value? I am a bit lost and the marketplace for pet insurance seems to be large and growing. The goal is to have a lot of coverage for, say, a $4,500 surgery as the result of something unexpected. What does everyone think?