Hey all I have to choose between some state medi-cal options for health insurance. The choices are community health, Molina healthcare and Blue shield healthcare. I've already dealt with Molina and I don't like them for my needs. So it's: Community Health vs. Blue shield. Context: My mother and I ( 55 F & 26 F) both suffer from certain health issues and will need specialists treatment, physical therapy and possibly even cardiology treatments (fingers crossed none of it is harmful). Some of these may even be genetic or hereditary, so appropriate testing and treatment are very important. We have either been diagnosed or have a probable diagnosis of some of these below 👇 Examples: •reynard's syndrome (a type of nerve condition) • Rheumatoid Arthritis • Wiggly Joints (causes wear of the joints and hyper mobility) Just to name a few. What I'm looking for is are there any miracle stories? Horror stories? Good experiences or bad? Which choice sounds the best for our needs of anyone can relate to us or has any experience looking for these things. TIA so much. P.S. I am still figuring out reddit so I may not be able to edit the post BUT I will reply in comments! Thank you!

Hi all - I was wondering what the likelihood that my Appeal that I finally sent in will be successful or if I'm just going to continue getting the runaround from United Healthcare. At this stage is it worth doing anything else (or do I have to wait until the Appeal plays out?) Some details... The claim that I filed with United Healthcare had all the correct, relevant, and necessary information including the in-network Tax ID, the Practice’s pertinent information, the doctor’s name, itemized receipts (two – one paid with FSA and one paid with credit card), and other pertinent claim-related information. United Healthcare processed the claim as out-of-network, but the Practice is in network, which made me receive +/- $3,000 less in reimbursement than I should have (due to that money going to an out-of-network deductible). I have called United Healthcare more than 15 times now across 3 months to see what else is needed and to fix the wrongly coded EOB and I’m always told that United Healthcare made a processing error and will fix it – but it never happens months and months later. The EOB erroneously states that this was an out of network event, but everything was in-network, and I have coverage for the procedure on my plan. Once again, every time I have called United Healthcare, they have told me that I’m right, that they are ‘backing out’ of the old claim and will fix it, and every time nothing has been fixed. I just called earlier this week, and the 15th advocate I spoke with (after taking 20 minutes to look over all the times I called and notes) said I was 100% absolutely correct, I should have received an EOB saying it was in-network, and the determination was wrong, but folks keep coding it – inexplicably – as out of network. She encouraged me to appeal....which I just did. Expectations of what may come next? Thank you.

Long story short, I was driving home from work in my work truck F150. I had merged lanes to the left after my lane had ended. I was completely in the new lane. Fully stopped when I was rear-ended by a car. Called the cops everyone was OK etc.. Both vehicles had a couple thousand dollars in damage. Luckily there was a witness who stopped and told the police that it looked like it was the other driver who rear-ended me. Call my Insurance tell them the story they tell me I’m at 0% fault. And then about an hour later, they call me back, saying the other driver with no insurance and no license called and filed a claim on my commercial insurance. To my insurance said I was 100% at fault. I proceeded to argue with the progressive insurance claims adjuster. He said that I was 100% at fault for changing lanes. Fast forward when I get the police report. Police report clearly states she is at fault. She rear-ended me she received multiple citations, including improper lane change no license no insurance. I sent the PDF of the police report to progressive and within minutes he called me saying I am at 0% fault. My question is, why did I have to go through all of this thinking I was at fault and worry about rates going up? already installed front back dashcam :)

I got diagnosed with sleep apnea and I was delaying my treatment because I found out that its very expensive. After a few months, the cpap company based in Houston, TX reached out again that my deductible has been met and I just owe 171$ and then insurance will take the charges. After I started my sleep apnea treatment, I got the call again from the medical company that they made a mistake on their end and the benefit information was not correct. So now, they are asking me to pay 45$ for supplies and 65$ for cpap rental every month till the payments are complete. I am just a loss of what the hell is this! I get screwed up and left with more charges for a treatment which was quoted wrongly to me. I called Blue Cross Blue Shield OF TX and they said they cannot help me. My current insurance is ending in one month and I am changing insurance from next month. So, it doesn’t make sense why pay deductible towards an insurance which will not be there in 30 days. What are my rights?

After 3 phone ,RESENDING MY CLAIM TWICE AND APPX TWO MONTH LATER THEY HAVE NOT PAID OUT MY CLAIM'. After less then enrolling a year since enrolling my 2 year old dog they raised my rate. when she turned 3, I never had so much issues when dealing with another company.

I recently found out that there were wrong 'occurences' under my name (list only) in family's auto insurance, which stated that i had two accidents between 2021-2023 "CLUE only". However, I did not have a license nor owned a car (my family only got the car in 2024). We had no previous insurance/cars, so these records were completely impossible and wrong. The insurance company asked me to contact LexisNexis to dispute and update it (because they said all insurance companies pulled that info from lexis nexis and there was nothing they could do to change it). Each time I called them, it was a min of 30 min on hold and when i finally got through to a live agent, they said their system was down so they could not authenticate anybody's ID and asked me to call back 24 hours later. I've been trying for 3 days, but each day an agent would tell me the same thing about their system being down/not able to help anybody at this point. LexisNexis also said that even after customers' ID were authenticated, it'd take 30 days to send a result by mail (another 7-10 days). It was a frustrating experience. Wonder if anybody had similar experience with wrong records from LexisNexis - thanks.

Question about marketplace insurance vs. private. My husband and I are partners in our own business so we got on a family marketplace plan this year after much due diligence on my part to ensure our providers were in network. We found out the hard way that just because some hospitals in a health network are covered, doesn't mean all are covered. This was upsetting to us because having both worked for the large health networks around us, we know where you go for procedures matters. I did a search of all marketplace plans for the 2 hospitals we prefer and NONE are in network. I got an email recently from an insurance broker who quoted me a price for Anthem BCBS that is a few hundred dollars cheaper a month than our marketplace plan including subsidies. There is a small deductible that I don't have with the marketplace plan and some limits on how often we can utilize a service but this would be OK with me if we could go to the hospitals we prefer. I'm also worried the healthcare subsidies will go away next year so finding a cheaper plan puts me a bit at ease. Is there anything I need to be super aware of with private plans? I'm curious how a private plan could be cheaper than a marketplace plan which is what is making me wonder if it's too good to be true. Thanks for any insight you can give!

My Honda CRV 2018 , 48k mileage was rear ended. Bumper damage and tail gate damage. Adjuster estimates says 3.5 K , the auto body shop says repair cost of 14.5 K and insurance company wants to do total loss and settlement of 21k. The shop **initially quoted $3,327.12**, but **after a deeper inspection**, the full cost is now estimated at **$14,412.00**. * This includes **parts ($7,059)**, **labor (body, paint, mechanical)**, **paint supplies**, **miscellaneous charges**, and **sales + county taxes**. # 🧾 What Was Added That Drove Up Cost? Here are some **major cost drivers** from the supplement: 1. **Rear Floor Pan Replacement**: * Part: $1,408.27 * Labor: 29 hours (!!!) * Paint: 2.5 hours 🔥 This is a **huge contributor**. Frame/floor pan replacement is structural and complex. 2. **Lift Gate Replacement**: * Part: $1,701.68 * Paint + labor included 🚨 Signals **major rear-end impact** 3. **Rear Body Panel**: * Part: $877.58 * Requires alignment and seam sealing 4. **Multiple panel repairs, refinishing, seam sealing, underbody work** 5. **Parts & Hardware**: * Several **aftermarket parts** were used to reduce cost (bumper cover, impact bar, moldings) * OEM parts were selectively used (e.g., optional OEM upper molding for $428.48) I am surprised with the high estimate. should I accept total loss and take 21K? anyway to negotiate higher. I was really not set for this time for another car purchase. My daughter is ready for college this fall was busy to manage her finance for college. should I try second opinion from another mechanic.

I own a condo, which I reside in. The unit directly above me is a rental property. So, a pipe was leaking from the unit above me. HOA says the upstairs unit is fully responsible for any costs incurred in repairing the pipe and restoring my bathroom due to the water damage it caused. The breakdown in cost for my Master Bath is as follows: \*Demolition:   $2,879.00 (already completed) \*Remodeling:  $4,554.39 TOTAL COST:   $7,433.39 The upstairs neighbor’s insurance company, Farmers, just paid me a total of $5,570.51 to cover all costs associated with the completed demolition and for the not-yet-started remodeling. That leaves a shortfall of $1,862.88 to make my bathroom “whole” again. Farmers explained that there is depreciation. My condo was built in 1986. I believe the bulk of the cost associated with restoring my bathroom is labor. Not the materials. Right? Since you can't depreciate labor costs, how can the insurance company justify paying out a significant amount less than what is needed to return my bathroom to the condition it was in before the water damage? For example, one item on the list the contractor submitted to the insurance estimate was $290 to hook the toilet back up and reset it. I asked the contractor how much the cost would be for the material to do that. He said all it takes is some wax. I asked him for a breakdown of material costs vs labor costs, and he said he can't come up with that because it's complicated, and the computer spits out the pricing already bundled together. This is my first time buying a place to live. So, I am not as familiar with all of this, and if I am being denied something I am entitled to from the upstairs owner's insurance. Here is a summary of what the General Contractor submitted to Farmers: Recap by Category O&P Items Total % CABINETRY 710.40 15.60% CLEANING 158.33 3.48% GENERAL DEMOLITION 182.82 4.01% DRYWALL 732.75 16.09% ELECTRICAL 214.02 4.70% FINISH CARPENTRY / TRIMWORK 280.02 6.15% HEAT, VENT & AIR CONDITIONING 13.28 0.29% INSULATION 49.76 1.09% LIGHT FIXTURES 58.29 1.28% MIRRORS & SHOWER DOORS 191.83 4.21% PLUMBING 581.01 12.76% PAINTING 564.27 12.39% O&P Items Subtotal 3,736.78 82.05% Material Sales Tax 58.47 1.28% Overhead 379.57 8.33% Profit 379.57 8.33% Total 4,554.39 100.00% Should Farmers have to pay the full amount to restore the bathroom to its original state? If not, how do I go about getting the remaining amount if I am not responsible for costs?

Has anyone subscribed to a Metlife cat insurance lately and selected the preventive care plan (375/575)? Are the individual limits (dental, Microchip, etc)clearly outlined in the policy packet? I bought a plan for my cat in March 2024, and there was no such limit (so the preventive care limit for a dental cleaning was the same as the original policy limit). I guess they were the only one to do that and they aligned with most other insurances.