Hi all, Hoping someone here can help me make sense of this or share advice on next steps. I recently had a BRCA genetic test done through Labcorp. Before the test, I received an estimate of $43.17 and got pre-authorization from Anthem. Everything looked good, so I went ahead. Now I’ve received an EOB from Anthem denying the claim. They say I’ve reached my “once per lifetime” limit for BRCA testing—and they’re expecting me to pay $3,000 out-of-pocket. I called Anthem, and they said the correct CPT codes were used and the denial is based solely on the lifetime limit. But I have never had BRCA testing before. It’s my first time. Anthem is now reviewing the case, but I’m trying to understand what might have gone wrong. My theory is that their system may have logged the pre-authorization itself as a completed test, and when the actual test was billed, it triggered the “second” test denial. Has anyone seen something like this happen? Thanks in advance!

Location: Houston, Texas On July 15th 2024, I was involved in an accident with a driver. It was a two-way street and I was at the middle crossing section ready to yield to the street I need to go. I noticed a driver coming out from the plaza and looked like they are waiting to cross to the street where I was coming from. Before yielding, I made sure no incoming cars and safe to go; attempted the yield. As I turned, the car from the plaza crossed the street and a collision happened where my front hit their side. Police was called but no report was made as they said it was minor. The other driver insisted the police to give me a ticket but they didn’t and sent us home after we exchanged insurance. After that, I did all my obligations with my insurance company and they denied claims from the other driver as they said it was not my fault and I had the right to yield. Fast forward to now, I received a paper said I’m being sued for personal injury but in remember the police asked the driver questions to determine if the driver need medical attention and the driver said no. I contacted my old insurance right away to inform them about the sue paper. I don’t know what to do from here.

I have messaged optumrx several times to stop automatically filling medications for me. I would like to do it manually because many times my doctors send orders for as needed medications that I use maybe once or twice a month and have years worth of usage from constantly having it sent. Despite attempts, they never fix the problem. What can I do? Age 28, state FL, gross income 80k

It takes them weeks to review claims. My dog had a diarrhea cause by a bacteria. My claim and appeal got denied because my dog had a diarrhea in 2021 and needed to prove that it’s not related. I even got a letter from my vet saying it’s a bacterial infection

I was laid off effective 3/31. (Thanks, Trump and Musk.) I filled out the application with PENNIE on 3/31. Got approved and told I have 60 days to select a plan. I called PA/PENNIE then. I didn't have my COBRA info yet so couldn't make an informed decision. I just logged back on to PENNIE and while it still says "you have 52 days to choose a plan," the effective date is coming up as May 1st, not retro to April 1st (like how COBRA works). I've called and the rep is not well-informed. The last time I called, another rep said "yes you can choose later and it goes retroactive."

Location: Indiana I have just been informed that my son's great grandma (who has never ever had her address used for our Medicare nor been approved to know anything about his or my medical info) has been receiving all of our Medicare information. I have over 5 letters for both him and I in regards to our benefit explanations, they even stopped his benefits and I had no idea!!! I'm upset because he has an upcoming appointment very soon for his 18 month check up and I don't even know if he will be covered by then. I have no idea how they even got her address. She recently moved, and I didn't even know her new address. But somehow, they have all went to her. I'm so confused as to how this has happened?! And I'm really mad that she had (if she chose to open the mail, but she did not open any of it) complete access to our information like that. What can I do about this? I plan on calling Medicare tomorrow but I really think this is a huge issue and I'm pissed honestly.

Is it even legal for Healthy Paws pet insurance to increase premiums at almost 200% in CA? This is outrageously high!! Anyone experiencing the same? #healthypawspetinsurance

Going from $113-$127, smh should I look into switching or would it be the same anyways?

I live and work in California for reference. I left my job to seek treatment for substance use disorder and Kaiser is claiming that they cannot excuse me since I did not participate in their outpatient program. I met with a doctor every week and he prescribed me medication to detox at home from fentanyl and methamphetamine. However they claim that this is not considered to be under a doctor's care and will not sign documentation for those dates. Over the course of 28 days I detoxed three times and relapsed three times before they sent me to a third party inpatient program. I am new to the Kaiser program as of this year and they recommended I go through their detox at home and outpatient program instead of directly to inpatient in spite of my long history of substance abuse and my multiple stays at detox facilities and residential facilities. Currently I am unprotected for these 28 days but I am wondering if this is legal?

My home insurance policy was up for renewal last October, and I ended up switching from Intact to RBC because the premium was lower. About a month later, I got a message saying that they wanted to do an inspection of my home. The inspector came and took some photos and told me that everything looked good and there shouldn’t be any major issues. Today, I received a registered letter telling me that my policy will be cancelled in 30 days due to “underwriting reasons”. I was unable to speak to anyone at RBC before they closed for the day, and will call first thing in the morning. I have no idea why they would cancel my policy. I’ve been continuously insured for over 10 years, have never missed a payment and didn’t withhold any information when I got my quote. I have had 2 claims in the past, but the last one was in 2016 so I didn’t declare it during the application because they asked if I had made any claims in the last 6 years. Has anyone had this happen before? I’m freaking out a bit because I understand that if you have an insurance policy cancelled on you it becomes harder to get insurance in the future. Any help or advice would be greatly appreciated, thanks!