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Insurance companies are constantly reviewing us. Are we too old? Do we live in the wrong place? Is our credit score high enough? Well, now it's time to turn the tables. Do you charge too much? Will you pay my claim quickly? Is your coverage worse than it seems? We can review you too.
Northwestern Mutual - Life and disability insurance question
Hi everyone, I got to this forum after seeing some "NW mutual life insurance is a scam" posts and i'm not sure if I got scammed. I was in medical training when a financial adviser told me about getting disability and life insurance.. with NW mutual... I'm 35 years old, very healthy, I pay about 87$ for 2M Term to 80 policy with no annual dividend. And my premium for disability is $110.. Looking for advice if I should switch to a different broker (if thats an option) or just general advice.
Priority Health - Two Private Insurances?? (I’m naive & I don’t understand insurance math)
I’m new to the private insurance world, so if anyone knows the answers to these questions, I will take any bit of knowledge given. Here’s what I’m working with:
**-Priority health - HMO ($1,300 family deductible) -Through my employer, Corewell Health**
**-State of Indiana Anthem - Healthsync POS with HSAS - ($6,000 family deductible) Through my husband’s employer in the state of Indiana**
* ***How do deductibles work? Policy states "You have to meet the deductible before coverage kicks in"?***
\[I’ve had Priority Health since 1/1/25 (Anthem did not become active until 3/1/25). Priority is saying I have met my family deductible of $1,300 but I am positive I have not paid anything remotely that close in office visit copays or on prescriptions. I’m happy about this, but it seems to me that I had some sort of coverage since the deductible is already met.\]
* ***Is it beneficial to notify both insurance companies so that they are aware of “the coordination of benefits”?***
* ***Can I pick who my primary insurance is (for doctors' appointments and prescriptions)? Or does it not matter who is primary and who is secondary?***
\[I might be speaking too soon, but despite the higher deductible, it seems like my husband’s insurance, Anthem, is better.\]
* ***Insurance math…??***
I recently picked up a prescription, and the pharmacy processed the insurance claims as follows:
* Priority Insurance (primary): $15 copay
* Anthem Insurance (secondary): $11 copay
The pharmacy combined the two insurances and calculated the total copay to be $7. I'm unsure if this was processed correctly.
My question is, with two private insurances, shouldn't the prescription be covered in full, resulting in a $0 copay?
Additionally, will I still be responsible for paying an office-visit copay for in-network doctor visits under both insurance plans?
\[My logic is that if I'm paying full premiums for two insurance companies, I should receive full coverage between the combined two insurance companies."\]
* ***Do I have to run both insurances when filling a prescription?***
\-My husband is prescribed disposable insulin pumps, which required a prior authorization. However, the PA process took months to complete due to communication issues between Corewell Health and Priority Insurance. Fortunately, his disposable insulin pumps are now fully covered by Priority Health. Here's the question: Until the prior authorization expires, is he required to file claims through Anthem when picking up refills? Note that Anthem became his new insurance provider on March 1, 2025, through his employer, and was not involved in the current prior authorization.
\[There are numerous prescriptions that Priority Insurance refuses to cover, but Anthem will. It seems like having to use both insurances could be a double-edged sword. The primary reason I have two private insurances is to mitigate the issues with prescription plan exclusions. Specifically, one insurance company will cover certain medications that the other will not, and vice versa.\]
Insurance company - Insurance cut me a check and then I had repairs but did I pay double $500 deduction
I swiped the side of my car (no lien) and Insurance company adjustor said take pics and put in portal. Said damage was worth$3700 and cut a check minus the $500 deduction; $3200. As I checked with bodyshops I deposited check as one guy said it doesn't hurt with final claim. Several weeks later used an insurance approved shop, over a month to repair. That shops original estimate was $5800 then final $7,700. So they charged me a $500 deductible and then Said to pay them the $3200 from insurance check. But Insurance check already took out $500 deductible and the shop just charged my CC $500. Shouldn't it be $2700 I pay Sthem (3200-minus $500) Insuirance already held theduditble and then I get charged by the body shop too?
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?
Health Insurance - Is this fraud? Health insurance added extra funds for prescriptions to my out-of-pocket maximum, but I am concerned it was a system error.
I picked up a few prescriptions in January for a Tier 2/$30 copays. This was a transition fill because my employer switched pharmacy benefits manager (PBM) and the medications were not on the new formulary. They said the lower cost was a grace period and standard of care while appealing for an Exception For Coverage.
A few weeks later my Exception For Coverage for the medications were approved so I paid Tier 3/30% coinsurance on the next fills in February. The Exception For Coverage was backdated to January 1st, 2025. Then, the following month it looks like the PBM reprocessed the January fills as a Tier 3/30% coinsurance and the additional cost was applied to my out-of-pocket maximum accumulator through my health insurance.
I'm not sure what is going on here? I called the PBM and was advised that they will not recoup cost from me and they will not ask the pharmacy to reprocess the claim. The OOP max was never mentions previously, but the representative confirmed that my current out-of-pocket maximum (with the added amount) was accurate as well.
Is this common practice for PBMs? Or, could it have been a system error? Has anyone else had something like this happen to them? I am so confused about this because I have not been billed for the additional increase in coinsurance from the PBM, but it feels like fraud since I know the numbers do not add up.
Fetch - Fetch Pet Insurance Prescription Sublimit
Hello, I am hoping someone can provide a bit of guidance as I’m a bit confused as to how my most recent claim was handled.
My Labrador has been on a fetch (formerly PetPlan) insurance policy since she was 12 weeks old. No issues with preexisting conditions and fetch covers a lot that some other insurances don’t when it comes to congenital issues. Recently she had to have TTA surgery to repair a torn knee ligament and we just got our reimbursement approved for the treatment
I noticed I was about 100 dollars short in my reimbursement, but received no communication that they partially approved or denied any part of the claim. I went and checked and they coded the surgical anesthetic medications under “prescription medication” and allocated all medications used during the surgery as prescriptions, which was applied toward the 1,500 sublimit I have on my plan for prescriptions
I have never seen this before and every single communication/review about fetch talks about how they covered surgeries in full and all that jazz, and it seems crazy to me that the anesthetic medications necessary for surgery would be coded the same as prescriptions and would prevent me from receiving a full reimbursement. Has anyone else experienced this with Fetch pet insurance?
I’m just concerned because it is likely she will need her other knee done and if it happens within the year then this entire surgery would have killed the entire prescription sublimit I have on my policy (that was also never communicated to me in the time I spent on the phone with the customer service agent)
Allstate - One side of Duplex Owner - Structural insurance
Hi,
i currently have All State for the one side of a duplex that i own. But they only cover up to the stud work. No structural.
I've asked them numerous times how do i insure the structure but i get no real answer.
How do i get structural insurance, foundation, frame, roof & then the rest MEP etc as the owner of one side of a duplex?
Progressive - Is my car toast?
Someone hit my car. Air bags went off on one side and bumper poked the radiator. Bumper and hood are crumpled but it doesnt look like anything else is damaged. No broken glass, and I can see under the hood and everything else is fine. Its a 2019 but good mileage and was in perfect condition prior. Filed insurance claim. It was the other personsfaultbut of course they didnt have insurance. Realistically what is the outcome? Weve had progressive for years. No claims for atleast 5 years.
Edit: sorry 2019 Jeep Cherokee
New York insurance - New York insurance is getting out of hand
I am looking everywhere for insurance and the best rates I could find are around $1,200+/mo for 10 months. I know I am a new driver but that price is WILD!! Any helpful comments would be appreciated.
Robinhood - Robinhood - possibility of wrongly linked IBAN to my account
Hello!
I was using robinhood app for crypto and everything was nice and smooth and I did not have any problems with transferring money from my account. I was living happily with the information that I can withdraw only money to the same account I was transferring it from. And there is the problem, I wanted to withdraw money to my account and after 2 months it's still not on my account.
I'm dealing with their support for those 2 months, I wanted to see full confirmation of the transaction, with the full IBAN number and they can't provide it "for security reasons". Also I have a suspicion the bank account linked to my account was wrong, but I didn't double check it before trying to withdraw the cash.
I have every single proof for every transaction coming from my account, it's exactly the same as seen on the app, I have proof there is yet nothing on my bank account. And I'm just out of ideas on how to make them solve things.
Is there anything I can do to make them handle this fastly or at least to make them send me the confirmation?
Thank you, every single help will be appreciated!
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