I'm a 24 year old male in NE with UnitedHealthcare. I make approximately $82k gross. I've had UHC for a few years now and have always done my yearly preventive checkup, which was always 100% covered until now. I've contacted both my provider and UHC trying to figure out why I'm suddenly being billed. When I check my claims, the labs given were mostly covered by my plan, with small amounts for each service charged to me. * Labs: * 80061 LIPID PANE, * 84439 ASSAY OF FREE THYROXINE, * 80050 GENERAL HEALTH PANEL, * 81001 URINALYSIS AUTO W/SCOPE, * 36415 COLL VENOUS BLD VENIPUNCTURE * If I have to pay my deductible before labs being covered, why are they covering ~77% of my cost anyways? If they're 100% covered, why do I have any deductible? * My insurance says it was coded incorrectly, but my provider says it was correct. * I asked my insurance to compare my previous years' coding to my current claim, and they said it was the exact same thing. CPT and Z codes. * I was given a follow-up call and sent [this pdf](https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/preventive-care-services.pdf) which details which codes are considered preventive, and I think I see my labs aren't? But I don't really understand what it all means, and either way it's the same coding as previous years, so why were they covered before but not now? Why cover them partially? * If the guidelines have changed, am I responsible for tracking that and telling my doctor what to do at my yearly checkups? * Is there a super simple explanation for why I'm being charged? Does the insurance have a max payout which the provider over-charged, leaving me to pay the rest? How can I tell? Thanks, this is all very confusing and frustrating to deal with. I don't know much about insurance or anything, but I feel like this is wrong somehow.

I have a long winded question. I want to preface this by saying I am not into fraud. I am a public employee and can’t have any issues related to that. 3 years ago we had a bad hail storm in the Chicago area. We have a close friend who is an adjuster for a roofing company. We coach our kids together and he tells me “hey do you want a new roof?” He tells me everyone is getting approved after the bad hail storm. I have zero experience with this so I said “of course.” I figured that’s why I pay insurance and this guy said it so non-chalantly so I agreed to it. He comes over, looks at the roof and submits a claim. A week or two later he tells me that our insurance denied a new roof and only said they would cover $1,000 in repairs. In my mind it’s a win since we get repairs done. Fast forward a year later and we have another hail storm. Our friend says to me “this time you will definitely get a new roof.” Again, we have no idea this is an issue. He looks at our roof and submits a claim. A week later we get a call from our agent and they tell us they are likely going to drop us. This is where my wife and I panic and wonder “what the hell is going on?” We get the insurance to stop the claim and somehow they do stop it and we don’t get dropped and don’t get the repairs done. So far no issues but still we are very worried about it. Since then we have had a few roofing companies out and the prices are crazy. Like 12k just to repair and 25k to replace the whole roof. My question is this: Would you recommend that we replace the roof on our dime? We have the money to do it. This is what I’m leaning towards but what happens if we have a really bad storm with significant damage? Does State Farm drop us but still have to pay for the damages or replacement? I don’t want to replace the roof, have significant damage, and then State Farm says nope you’re dropped and we aren’t paying? OR, should I switch insurance companies before any work and then replace my roof anyway to lower the premium cost with a new insurance company? Insurance prices are ridiculous right now but state farm is still lower than any other insurance company I have had quotes from. Thank you for any advice you can provide. Edit: I agree with all the comments that the guy screwed me. I am aware that the claims follow me. I need to find an honest person who can tell me if I really need a roof replacement. If not, I’m willing to ride it out until I do actually need a replacement. The thought of doing it now came because in 5 years we will have 2 in college and one in high school. We figured we would take the expense now rather than in a few years when money is a bit tighter. Still unsure of what we will do. I don’t think I need a new roof immediately but I know it will be in the next 5-10 years.

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.

Every six months I get a big envelope from Statefarm with all my car insurance details and prices. It also comes with a bunch of small booklets, think they are called "endorsements". Anyways the one I got said I would owe around $350 . It also says "This is not a bill". Now today I got my bill electronically. But it says I owe $450+. Unfortunately, I recycled the original paper bill that said I should owe $350. Was that $350 likely for some shorter duration? I did remove something from my insurance a few weeks ago so maybe they sent me some pro-rated amounts?

I had gone to a new dentist in October 2024 for a routine cleaning and was essentially "upsold" on the removal of my four wisdom teeth, as I had mentioned they were bothering me. I was told my insurance was accepted (MetLife) and that I would only pay $300 for the removal. I figured that was a great deal and had my teeth removed, paying the $300 on my way out. I received an email earlier today for a separate claim from Cigna, and decided to look at my MetLife portal as I remembered the dental claim being stuck on "pending" for some time after the procedure. According to MetLife, the cleaning and x-rays were in-network and 100% covered, but for the wisdom teeth removal, the claim was marked as out of network and my patient responsibility is $800. It has been a bit over 4 months since the procedure and I haven't received a bill from the provider - should I just leave things as they are or should I contact my insurance provider/dentist? I only accepted the procedure because of how affordable it was and confirmed with my dentist multiple times that $300 was my total cost for all 4 teeth after insurance.

My puppy recently got a tick bite and showed positive on Lyme disease after testing. Did more testing to see if treatment is required. Pet insurance denied my claim because I didn’t buy him the vaccine for Lyme disease offered by Vet. I have bought both internal and external de-wormer through Vet and PetSmart with records. I am trying to appeal this but want to know if I am supposed to buy that vaccine at the first place? Am I supposed to buy anything Vet offered to make further claims approved?

My BCBS refused to pay any of my blood work. I was referred by my doctor to go to a specialist to get blood work done, over 6 months ago. Now I got this bill in the mail from Quest and found my EOB. They coded it 002 as “we do not cover experimental or investigational procedures” Ok…isn’t the entire point of blood work to investigate? Anyway, should I call my insurance or the specialist to appeal the bill? Any advice? This has never happened to me before. Thank you!

I am 24, and I got my license at 19. In the past 3 years I have had 3 accidents, 2 of which the car was totaled/not worth repairing. We have Geico, and to renew the plan with me on it they’re charging is about 8k per 6 months, or about 1300 a month. When my dad tried to shop around, the only other company willing to take us on with myself as a driver was Progressive, and when all the details were filled out they wanted to charge us even more. Since I am a member of the household with a license, I have to be on any car insurance plan he gets. We have two other cars, so selling my car wouldn’t impact my dad. I was thinking that after selling my car, I could use the money to pay for ride-sharing. Also: if I turn in my license now and try to renew it next year, will the premiums go down or stay the same?

Ok so this is totally my fault for not reading the policy documents, but the Trupanion deductibles are PER CONDITION, not annual. This means every time your puppy visits for a new condition, the $500 restarts. The idea is that once the deductible for a condition is met, your pet is covered for life for that condition without having to meet deductibles again. Our puppy had splinters stuck in his tonsils and had to be sedated to have them removed. The total bill was $750, and between "examination fees" and the new $500 deductible (we have already submitted claims for other things), nothing was covered. Here is the kicker, they not only didn't cover the examination/consultation fee, they also denied the "esophageal examination" which was the procedure to pull splinters out because of the word "examination". Here is ANOTHER kicker, if something gets stuck in his throat again, it would be considered a separate incidence, so the $500 will restart again! If your puppy gets giardia, it clears up, and he gets it again in 3 months, guess what, the $500 restarts! I can see that this would be a good policy for older pets with chronic conditions, so you don't need to meet deductibles every year, but for a healthy puppy who gets into accidents from time to time, every incidence is considered separately, so mostly likely much of your expense will not be covered! I'm switching back to another insurance that my 5 year old girl is on. I wanted to try Trupanion because I kept seeing ads for it, but now I'm going to switch both of my pups to be with the same company while my puppy is still young before "pre-existing conditions" develop.

I have UPMC Advantage health Insurance and was taking Vascepa (icosapent ethy) and then the script went to $450 for a 3 month supply. In January i used a coupon from the Vascepa website and was able to get the medicine for $9!! ($3 per month) I just went back to the pharmacy yesterday (Giant Eagle) and they said that because UPMC no longer covers "Vascepa" I'd have to get the generic icosapent ethy, for which there is no coupon and it would cost $150 ($50 per month). Does anyone know how to get icosapent ethy for less? Also, why isnt there more outrage at the fact that our health insurers are constantly TAKING away from our plans and making it more expensive to get medicines we need?