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Anthem Blue Cross Blue Shield - Contradictory EOB? Let's play the in-network or not game.
What am I missing here? It looks like Anthem BCBS is acknowledging my provider is in-network and then processing it as out-of-network.
* Provider has been processed as in-network for visits both before and after the visit in question, always with a $30 copay and no balance. This was another routine, non-emergency visit with the exact same provider.
* EOB clearly says in big bold print that "Going to this doctor uses in-network benefits" and elsewhere has the words "(in your plan)" after the provider's name.
* EOB shows no copay, a portion applied to my deductible, and a balance in the "Your total cost" column.
* EOB gives a reason code: "015: The amount shown here is more than your plan allows for this care. If this was not an emergency, the doctor/facility might bill you for the difference between what your plan allowed and what the doctor/facility charged."
How is this possible for an in-network provider? It seems this EOB is just contradictory on its face. I've been trying to get them to fix it, but haven't had any success yet. Any advice?
State Farm - Has anyone had any issues with State Farm safe and save?
So my driving record is pretty good, all of my scores are at 100. Last month in June, I was getting on the interstate and had to pick up speed quickly so I got marked for acceleration and cornering. Those 2 events brought me down to 60 something from 1 time. Usually after I have an event, it doesn't take long for me to get back up to 100 as I don't like to accelerate as quick. It's been over a month with no other events and it won't go up. I drove yesterday and my score was 89 for acceleration and 88 for cornering. After my 3 trips I checked the app and hour later and it went up to 90 and 89. This morning I get back on and it dropped both to 88 even though I haven't driven since yesterday. I called 3 customer service lines and my local state farm representative and I'm getting the run around. My 6 months discount is for August so I'm wondering if it's doing this intentionally so I don't get as big as a discount when I'm up to 100 for everything.
MetLife - Thinking of getting MetLife pet insurance for my dog
I’m thinking about getting MetLife pet insurance for my dog and wanna know if it’s actually worth it. I’ve seen they cover stuff like vaccines, dental cleanings, flea/tick meds and give about 80% back after a $250 deductible. The price seems okay too.
But I’ve also heard some people had their claims denied for weird reasons (like needing medical records from before they adopted their dog which makes no sense). So I’m kinda torn.
Would really appreciate honest opinions. Thanks.
Progressive - Canceling a claim
So I hit someone’s car and the damage was very minimal. Just a tiny dent and a scratch. I filed a claim, and the guy I hit said the damage was minimal so he wasn’t going to file one. I called yesterday to cancel and was told by progressive I would get a call today. I get a call and let the lady know I wanted to cancel because of the reason provided. She then gives me attitude over the phone and we hangup the call. What do I do in this situation ?
PetsBest - PetsBest
How long does it usually take for PetsBest to reimburse you? For some reason, it says that my payment date was April 3, but I haven’t received anything
Lemonade - Claim Denied!
I have Lemonade and they denied my claim because the covered illness was “discounted” on my invoice showing nothing due. I have a care plan through my vet that I’m paying $150 a month for. I submitted a claim for the exam and testing that my dog received which was included in my care plan. Am I wrong for expecting Lemonade to reimburse for this? Even though the invoice shows no charges, it’s only because I’ve been paying in advance with my care plan. I’ve had pet insurance before (24 Hour Pet Watch) and they reimbursed me for things that were included in my vets care plan. I see nothing in my policy that states they don’t reimburse what your care plan covers. They told me their “guidelines” say it will not be paid. I’m thinking about filing a complaint and canceling my policies with them.
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?
Trupanion - Wellness Plan Recommendations for Sphynx Cats?
I have a pair of Sphynx cats—both female, spayed, and 1.5 years old.
Right now, I have Trupanion for their pet insurance, and overall, I’ve had a good experience with them. That said, one of my girls had an allergic reaction earlier this year that required multiple follow-up visits, and the out-of-pocket costs for exams alone really added up. I reached out to Trupanion, and they said I’m allowed to have a separate wellness plan from another provider to help cover things like exam fees and routine care.
So now I’m on the hunt for a solid wellness plan—mainly one that covers exams, vaccines, and most importantly, the annual HCM screening for both girls. Trupanion might or might not cover that since it’s kind of a gray area between diagnostic and preventive. I’m betting they’ll treat it as preventive, so I want a backup plan.
Any recommendations for wellness plans or other insurance options? Every time I think I’ve found a good one, I come across a flood of awful reviews (though I know that’s just the nature of insurance). I do plan to call and confirm coverage details before signing up, and I’ll also ask if they can review my girls’ vet records to determine what they’d consider pre-existing.
Thanks in advance for any suggestions!
USAA - Insurance trying to total a non-totaled car?
Sorry everyone this is a long one and I don’t have a good way to TLDR it.
Just for a quick note, I have USAA for auto insurance and my vehicle is a 2017 Corvette Z06 in 3LZ trim, Z07 package, and 52k miles. I own the car outright and it is titled/registered in NH.
So a little while ago I was driving in heavy rain, hydroplaned, lost control, hit another car in a few places not too hard, and slid into the median. The cosmetic damage is pretty bad. A few body panels and aerodynamic parts of the car were damaged and will need to be completely replaced, as you can’t repair fiberglass/carbon fiber. I estimated myself that the cosmetic damage alone would cost $25-$30k (take that for what it is, I’m not expert lol). I had a chance to look under the car and nothing looked terrible - only thing of concern was a rear wheel that was canted slightly outwards. I towed it to a shop and they’ve found no frame damage; they’re saying it’s completely repairable. USAA got an adjuster to do an estimate on the repairs and it came out to almost $32k without having taken apart the vehicle. Their estimate also included a substantial amount of work being done on the rear suspension, if needed, which is probably the only mechanical part of the car which would’ve been damaged. Their Actual Cash Value (ACV) for the car came out to be almost $61k at the time, and since the repairs were estimated to be over 50% of the ACV, they deemed it a total loss immediately. But I knew that ACV was wrong, because no low ballers, I know what I got. In all seriousness, their report included the methodology for calculating the ACV - they compare my car to two similar cars for sale in the area. However they made a mistake and compared my car to two base model Corvettes which, brand new, went for anywhere from $30k-$45k cheaper at MSRP. They also left out very valuable features my car had as OEM equipment like the carbon ceramic brakes which go for about $16k brand new. Obviously I know I’m not getting full value for these things, I’m just saying they certainly add value. Anyway, they admitted their mistake in comparing my car to two non-comparable vehicles and redid the calculation. The new ACV is almost $87k now.
Now, I know a lot of you if not all of you will say take the money and run, but this is a dream car for me - it’s spec’d perfectly and I’ve done a lot of work on this car all by myself, so it has a lot of meaning for me. I could take the owner retainment settlement option and receive $48k, repair the car myself, and pocket extra money (because I know these repairs wouldn’t cost more than $48k), but they would issue a salvage title, and I couldn’t do that because I’d still want full coverage on the car. But even with this new (and correct) ACV, USAA refuses to not call this car a total loss. Repairs would have to exceed $43k to be over 50% ACV and, by their own definition, be a total loss. Additionally, in the state of NH, generally when a vehicle is involved in a collision the damages need to exceed 75% of the ACV to be deemed a total loss.
This is what USAA has recently sent me as I’m still fighting them to get the repairs done,
“I can understand your point, however there was no mistake in deeming the vehicle a total loss at start, you were interested in more value in the settlement. The fact that the added value was reviewed doesn't remove it from a total loss stance. We still report it to the State as a total loss, the features and conditions that were modified as a courtesy increased the value here.”
So my question is, can they do this? Still deem it a total loss even though from the start their calculation of the ACV was incorrect?
I disagreed the car was a total loss from the very beginning, I wasn’t looking to get more money from the settlement, I just wanted to ACV to be correct. I’m not even looking to pocket any money from this, I just want my car fixed.
Fetch - Fetch insurance deleted my pet’s medical records!!
I just thought about checking on my fetch insurance, went on to the medical record page, and found out that ALL my pet’s medical records were deleted!!! It says no medical records at all, but I’ve been updating my pet’s medical record since I adopted him in 2023.
There are 4 records that I updated, including annual wellness check and initial baseline.
I have the confirmation of medical records emails from fetch last year.
I called them and reuploaded all the files. The customer service was nice but she said that she has no idea why this happened, and no further clarification on how to prevent this in the future.
This feels so shady. Everyone with Fetch, please have the habit to check on your records regularly, because I’ve had experiences of them refusing my claim because I didn’t post annuals check up record every year.
I can’t even imagine what could’ve happened if I didn’t think about checking the insurance today… still in shock
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