I noticed on my renewal for my auto policy with Progressive that I was listed in tier 3M. Google told me this is a high risk tier, but I have been driving for many years, have a clean driving record, and no claims. I am, based on my driving record and insurance history, a low risk driver. Is this a high risk tier? Does anyone know how these tiers are assigned? If I am incorrectly assigned to the wrong tier, how do I fix that?

Ins: State Farm I got into a wreck that I was deemed at-fault for in May 2024. My auto policy at that time renewed from Feb 2024-August 2024. In August 2024, they renewed me again and raised my rate (obviously). Then in December 2024, I received a letter from State Farm saying they weren’t renewing me (Feb 2025-Aug 2025) for being high-risk and I had to find new coverage. So my question is: Why did they renew me again in August 2024? Why didn’t they just non-renew me at that point?

When I call an in-network practice, they usually tell me the next available appointment is in four to six weeks—or that the doctor isn’t taking new patients, it goes without saying all of this is contrary to information updated by my insurance weekly. I push a little or ask about seeing an available doctor, the conversation suddenly shifts to my insurance. As soon as they find out I have a subsidized plan, I sometimes get told they don’t accept it. Is this happening because of recent changes in federal policies, budgets, or staffing? Are providers running into issues processing claims from these plans?

Just a little PSA for people who weren't aware, when you move you may lose access to your old policy. I've had my policy for 2 years and in that time one of my cats turned 15. because I'm moving, they are charging me a deductible again and also won't cover my cat on the same plan anymore due to age. I'm going from 80% coverage on an unlimited amount to a cap of $2,500. in a HCOL area. I'm obviously devastated but just wanted to share. might have chosen a different place to live if I'd known how screwed I would be.

I recently had to have an in-patient EEG. The neurologist said they'd call my insurance (Aetna) for pre-approval before moving forward with booking. I received a call saying that it was completely covered and to move forward with procedure. I check-in with no mention of payment and checked-out with no mention of payment. Cut to now about a month later and I receive a bill for $7,000. Apparently, insurance only offered partial coverage though I was told by my provider it will be completely covered. Do I have any recourse in this?

Location: Georgia, USA Hello everyone- My brother was in a motorcycle accident April 6, 2024. He was in ICU for a month and discharged in July, 2024. During that time he did not have his phone, access to email, or ability to check standard mail. My brother was a PE Teacher and football coach in the state of Georgia for 27 years. All of his insurance premiums were paid for once a month in his paycheck. The state of Georgia agreed to early retirement with benefits beginning July 2024. Blue Cross informed him last month they were dropping his insurance for delinquent payments. His appeal was denied. My brother is looking into COBRA as well as ACA. Does my brother have a case agains Blue Cross? What steps should he take to have Blue Cross reinstate him? Thanks!

Hi. I have an HO3 policy with Citizens in Florida and I’m trying to understand in what situations they would actually cover water damage since the reps, my insurance agent or adjuster are not able to clarify this. I have a water damage under my flooring, but again neither the field adjuster, water mitigation company, nor the leak detection specialist have been able to find the exact source of the leak. Insurance wants to send out an inspector who I assume would work in their favor. I’m trying to prepare in case they deny my claim and I need to bring in independent specialists to help me figure it out. I have vinyl flooring installed on top of hardwood floor, and noticed a soft spot so I removed part of the vinyl and found rotten wood. I've never noticed any water on top of my flooring. From what I understand, Citizens excludes gradual leaks and seepage, but they have a clause that covers hidden water damage if it was unknown and concealed beneath floors, behind walls, or in ceilings. I’m wondering how that actually works in practice. Since there's no known active leak it must be caused by something situational, hidden or accidental spill. I'm having a hard time determining the fine prints since it gives conflicting information. I've included a few pages from my insurance declaration related to water damage in link below: https://imgur.com/a/sc50G9K Would Citizens cover situations like: - Moisture buildup under flooring due to a failed vapor or moisture barrier? - An AC leak inside the walls over time from a pipe failure or faulty installation? - Sporadic leaks from an air handler that was poorly installed? - A cracked condensate line or even a sewage pipe leaking beneath the slab? - Water spilled sometime in the past which got under the floor? Has anyone had Citizens approve a claim for something like this, or did they deny it as a maintenance issue? If they did cover it, what kind of evidence did you need to provide? I want to be ready in case they push back on the claim. It's been over a month already and I am not able to get the renovations started since adjuster wants me to keep it as is for now. On top of that the adjuster wanted me to keep the damaged flooring (with mold) bagged indoors. And he also advised that we live home since the mold did not seem to be a big issue from what he was able to tell from the photos (despite water mitigation company saying that it was over 10sq ft and asked that we find temporary stay since we have a small child until they send a higienist, which they did not get an approval for from adjuster)... I would really appreciate your help. Thanks

I picked up a few prescriptions in January for a Tier 2/$30 copays. This was a transition fill because my employer switched pharmacy benefits manager (PBM) and the medications were not on the new formulary. They said the lower cost was a grace period and standard of care while appealing for an Exception For Coverage. A few weeks later my Exception For Coverage for the medications were approved so I paid Tier 3/30% coinsurance on the next fills in February. The Exception For Coverage was backdated to January 1st, 2025. Then, the following month it looks like the PBM reprocessed the January fills as a Tier 3/30% coinsurance and the additional cost was applied to my out-of-pocket maximum accumulator through my health insurance. I'm not sure what is going on here? I called the PBM and was advised that they will not recoup cost from me and they will not ask the pharmacy to reprocess the claim. The OOP max was never mentions previously, but the representative confirmed that my current out-of-pocket maximum (with the added amount) was accurate as well. Is this common practice for PBMs? Or, could it have been a system error? Has anyone else had something like this happen to them? I am so confused about this because I have not been billed for the additional increase in coinsurance from the PBM, but it feels like fraud since I know the numbers do not add up.

My dog has been with Trupanion for 5 years. She was healthy as a horse when we switched her, so I thought we were in the clear for no pre-existing conditions. Obviously, naive. Anyways, they are rejecting all tooth extraction claims because a vet wrote "mild tartar" one time in her records 5 years ago. The vet never said anything to us about her teeth until this year, when they told us she needed extractions due to bone loss in her jaw. The vet says it should be covered, but they rejected the claim and I am not holding out hope for the appeal. I am considering switching her to AKC. They won't cover her teeth either - but I can get a high-deductible plan with hereditary plus coverage for $70 per month. It would cover pre-existing conditions after 365 days, according to the person I spoke with. So I could save over $30 per month, that could go towards her inevitable future extractions. My thinking is that I now understand that the insurance companies can turn anything into a pre-existing condition post-hoc. I don't trust Trupanion to not do that again. At least with AKC, they cover pre-existing conditions so if she ever got cancer on her ear, for example, it wouldn't be excluded just because she had an ear infection in 2020. Is this thinking sound? Has anyone switched to AKC and could give some advice? https://preview.redd.it/8r3nxzh7yqke1.jpg?width=4080&format=pjpg&auto=webp&s=5bdb9dc183f9cb9d286aec2404203e53dbdbe5cc

Amy guidance is appreciated. I was driving down a street when a car t-boned me, I spun around in oncoming traffic. I was able to move my car safely. The driver who hit me walks up and says it is his fault. I get my phone out and start recording, I asked him to say it again, he asked if I was recording, I said yes. He said that was fine but when I asked him to repeat what he said, he said it to let the insurance company handle it and laughed. I get taken the to ER just to be safe and I was released shortly. I was given a 2 day work off work note. I immediately reported it to my insurance company. They said they will reimburse me for my medical. The other driver admitted to his insurance that it was his fault so my insurance waived my deductible and will pay for my rental car for 30 days but my insurance will not pay for my lost wages. 2 days later I go to urgent care because now I'm feeling it and I get another doctors note to take me off work for a few more days. I'm very nervous to drive. Now, the other insurance company seems very eager to pay my lost wages, any physical therapy, all my medical, etc. I'm just skeptical they seem so willing to pay. What information should I give them access to and what should I not? What if they have me sign something, what should I look for or make sure I am not being hustled? Any guidance is appreciated. I'm new to this.