I have read some prior threads for this but they are from a year ago and I'm curious if there have been any changes. Background: I have had UHC and used Optum for my specialty pharmacy for years. My specialty medication is a biologic with no generic equivalent. The manufacturer provides me with both a copay card and a payment card. My deductible has consistently been met in January every year using the payment card, and then the copay card picks up the copay for each month for the rest of the year. Situation: This year, the manufacturer payment card was processed as usual and applied towards my deductible, however, they went back a few weeks later and reversed it from my deductible. When I called them, they said nothing has changed and the payment card, as a form of manufacturer assistance, cannot be applied towards my deductible, despite that having always been the case. Based on what I have read about an HHS ruling, they are required to apply this towards my deductible as there is not a generic available. I filed an appeal and was denied. My employer plan is likely self funded, but from what I have read, that should not matter. Has anyone gotten a resolution to this issue?

26, California, $37,000. My health insurance provider denied me access to estradiol for the purpose of gender transition (MtF). I was prescribed this by my doctor and they called me to inform me that my insurance excludes anything under gender related health care according to a denial letter they got from the company. Blue Cross Blue Shield Kansas City provides the health care in Missouri because of the company being nationwide, although I am based in California. I have yet to receive a copy of the denial letter myself, but plan to get a copy of the one from my doctor's office if I don't receive one in the mail this following week from the company. According to the BCBSKS website they do cover gender transition and when I started this job I asked them if it was covered. My H.R. representative seemed confused about the denial and said she'd look into it as she'd never run into this before. She also that they supposedly cover gender related surgery at a certain percentage so something seems fishy. Is this a recent policy change? What are my options? I'm currently filing a complaint through my recently formed union at the company and will be using GoodRx to be able to afford it, but now I'm worried if I tried to receive anything else transition related and am frustrated it won't go towards a deductible. I don't have the letter of denial yet. Will I be able to appeal with information on the letter? Is this legal since I am a California resident or is it all purely through Missouri laws? Just looking for advice.

I’ve had liberty mutual since i leased my Jetta in 2021. My rate was $145/month until jul 2023, when my coverage renewed and then it increased to $197. Then increased again to $225 in jul 2024. I called and spoke to an agent to ask about the increase and they said it had nothing to do with my credit and that rates were simply rising across the board… In 2022 I had a small fender bender with someone while parking, my insurance covered it i think. I never followed up with my insurance to see if they actually filed a claim. In 2023 my car was side swiped by someone parallel parking and they left a note and their insurance covered the damage and repair. But that was the only accident i had. No speeding tickets, but i did have many parking tickets (my city is brutal). Now I’m wondering if I should shop around, but seeing other peoples posts im not sure if $225 is even that high rn? My credit score is 759 and I make $72,800 a year before tax.

I’m really hoping someone who works in medical billing at a dentist office can help me understand this. For context, I have Cigna Dental PPO. I had an oral consultation today that cost $167. The oral surgeon said I definitely need the bottom ones removed, but said she isn’t worried about the top ones. Then here is an image of what I was quoted after. They said I would either be paying $5809 or $3789 depending on what my insurance says. She didn’t sound confident in what she was saying and was speaking to someone else prior. Then, they tried to make me schedule it with 50% down as if I have $1800-2900 just laying around. I could barely afford the consultation fee. I’m I being got or is this how much people are paying to get their wisdom teeth removed? I’m so lost…

My 14 month old cat has been to the emergency vet twice since we adopted her a year ago. 8 weeks ago she went in for swallowing a button. She had been vomiting all day. Luckily it came out naturally after she spent the day hospitalized with an iv to hydrate her. Last week she started vomiting again. I’ve been traumatized but the fact that she swallowed a button, my best friend’s cat had to have surgery to removed a nerf ball, and my other best friend’s cat had to actually be put down for eating the rubber off of swimming goggles, he had other issues and they didn’t think he would survive the surgery. All this happened since my cat first went in 8 weeks ago. So I probably should have given my cat a few more hours to see if she would stop vomiting. Turns out she had suspected gastritis. Now I’m afraid that we will get dropped from Fetch insurance if I submit the last claim. Should I submit the claim? Will I get into trouble if I don’t submit it?

Hi all, I'm leaving my current job and I have another position that pays higher than where I'm at right now, but no employee health plan. I'm in CA. Right now I'm looking at marketplace plans for my spouse (33M) and I (31F). We don't use much when it comes to health care. A few random visits here and there, I take a few daily mental health meds but that's it. However, we do want to start a family in the next year so I'm trying to keep that in mind. I've always been on an employer PPO, so that's what I'm used to. My top options currently are Blue Shield of CA PPO, or Kaiser Gold HMO. From what I've seen blue shield is one of the few companies that will offer PPO on the marketplace. I've looked at some of the cheaper plans through multiple companies but since most of them have coinsurance, I worry I could rack up quite a bit if I were to get pregnant/deliver. We earn too much to qualify for financial help/ACA plans as well. Here's my question - how much does Kaiser's HMO plans differ from their PPO? Is it really a big difference since it's all in one system? I know there are issues with Kaiser and it seems people either love it or hate it. But it seems like their HMO plan is cheaper with better coverage (particularly for maternity) than a similar PPO through blue shield. Anything I'm missing here? Any advise or prior experiences would be helpful.

Hey folks, I’m dealing with a frustrating situation involving my apartment’s property management and my insurance company, and I could really use some advice. There was a minor fire accident in my apartment, and the total bill is under $5,000. My renter’s insurance is willing to cover the cost, but they require the property management to sign a release form. The problem is, the property management’s legal team wants to make edits to the form, but my insurance company’s legal team won’t allow any modifications. So now I’m stuck in this deadlock where: • My insurance won’t pay without the signed release form. • The property management won’t sign it unless they can edit it. • My insurance won’t accept any edits. I feel like I’m caught in the middle with no way to move forward. Has anyone dealt with something similar? Any suggestions on how to break this stalemate? I just want to get this resolved without it dragging on forever. Would appreciate any insights!

I managed two older buildings one built in 1950 and one built in 1900. The company's own them for 13 years and never had a insurance claim. Country financial, which is owned by Farmers I believe, did a risk analysis is dropping 45% of their older homes Are there any companies out there that are easier to cover older rental properties with older rust but still in good condition?

I’m a 19F college student in Maryland and need a PPO plan because my school is in DC. I aged out of Medicaid, and since Maryland’s enrollment period is closed, I can’t reapply until November-January. I contacted a health insurance agent, but they mistakenly listed me as male on the application. When US Health Group called to verify my info, they corrected the error, and my quote jumped from 140 to 160/month. I am a broke college student with no job. The agent is trying to "fix" it and get us back to the original quote, but I’m worried this mistake of his will bite me in the ass when I'm older as he is now playing with the deductible in case of a life threatening emergency (before it was 8k I'd have to pay out of pocket and now its +20k). I don't know what to do as I've never had to deal with insurance! Should I switch agents, as the gender was a mistake? Please help!

I had to get a new car unexpectedly in April. My AAA car insurance period was Feb-Aug. Called them on April 7 to let them know I got a new car and the premium was crazy, but you can't drive without insurance so I kept it. Shopped around and got a new policy for much cheaper starting May 1. Called and cancelled AAA and the agent said I might get billed a cancellation fee. NBD I thought. Nope. My pro-rated term premium was $840. My payment due after cancelling was $310! The math ain't mathing. $840 for coverage from April to August comes out to $168/ month. I wasn't even covered by the new rate for a full month. I've already called and the agent just said its a combination of things like the short rate and cancellation fee, but she can't give me an itemized breakdown of charges. Anyone got any advice? Is there a way to get out of paying this or at least getting them to come down?