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    Tuesday, December 5, 2017

    STD denied....need help Insurance

    STD denied....need help Insurance


    STD denied....need help

    Posted: 04 Dec 2017 05:16 PM PST

    All,

    My wife is healthy in all other ways except she has Psoriasis that she manages with Enbrel. A new dermatologist thought it was a good idea to switch something that wasn't broken and put her on Humira. Well, month went by and she started having joint pains. Then it became really swollen joints. So she went to doctor and they switched her back to Enbrel and everything went away.

    On her STD form, she put psoriatic arthritis. I am under the belief that she had drug induced psoriatic arthritis from Humira, which is a symptom.

    Well, come to get a letter in the mail stating that it is denied because of "history of Psoriasis and Psoriatic Arthritis".

    I told her she needs to call her Rheuma and get him to clarify what she has and doesn't have.

    If it moves to drug induced PA, is it any better?

    The good news is that it really doesn't make or break anything. The reason we want her on STD is so she can qualify for the 5 weeks,100% paid maternity leave when we want another child.

    Any help would be great.

    Thanks for the downvote lurker.

    submitted by /u/RantBitch_
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    AINS23 exam

    Posted: 04 Dec 2017 08:34 PM PST

    What is passing for institutes exams? I know you get pass or fail but is a 70 considered passing or do you have to get an 80? I'm taking AINS23 coming up & im doing terrible on the practice quizzes. I'm hoping for the best but not feeling optimistic. Any last minute advice for me?

    submitted by /u/onlymehere
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    First accident, not at fault, other driver didn't have insurance.

    Posted: 04 Dec 2017 12:32 PM PST

    I was rear ended earlier today. I called the police once asking the person involved if they were ok. The other person informed me she did not have insurance. I called the police and he filed a report. I called my insurance and filed my claim, am going to send them photos and dash cam footage I have. My insurance told me I would be responsible for half of my standard deductible. This just does not seem right to me, does anyone have advice or know the law in Texas for something like this? Thank you ahead of time!

    submitted by /u/dWeisse
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    Best dental insurance?

    Posted: 04 Dec 2017 09:39 PM PST

    I've been scouring the internet for dental insurance all day today and have gotten no closer to figuring out what is best for me and my husband. Here's the situation: I'm a 22 y/o female married to a 22 y/o male who was medically retired from the military. We live in California and are both full time college students completely supporting ourselves. Growing up I had regular dental check ups and got all the dental care I needed and never had insurance. Since getting married, my wisdom teeth (I only have 3) are coming in and starting to cause problems (one tooth in front looks like it's dying and I'm sure it's connected to the wisdom teeth), and I also have a botched filling that's been causing me sharp pain and the inability to chew on one side of my mouth for a year and a half. I could get retiree dental from Tricare but it's $90 a month and from what I can tell has average coverage. That price point is above what I'm comfortable spending as well. I'd be comfortable with about $50-60 per month for the two of us. I have looked at so many insurance options and they cost anywhere from $20-150 a month and honestly all look similar in coverage! I have no idea what to do but I want my mouth to stop hurting before things get way worse. Thanks in advance!

    submitted by /u/Ohquinn
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    Car scratched; no insurance information?

    Posted: 04 Dec 2017 08:04 PM PST

    Returned to my car and someone had scratched my bumper. Nothing serious. They left a note and a number, no insurance information. Can I report this as a claim to my insurer and be covered for the cost of repair?

    Also, is there any way that I can file a claim against the person who scratched my car? The chance is small, but if I ask for security footage that may help me get the license number. Will having a license number help my claim?

    Thanks for reading.

    submitted by /u/gongheyfatchoi1992
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    Backed into a car while backing out of parking spot

    Posted: 04 Dec 2017 03:19 PM PST

    I was parked on the street at the end of the street. No car was behind me when I got in my car and there wasn't anywhere to park behind me legally so I didn't look and backed into a delivery driver who just pulled up and was parked illegally to run into pick up deliveries.I Stupidnted the hood/grill on his 2001 car. My car is fine.

    I'd rather pay out of pocket to fix it. Can I just do this myself? Do I need to go through insurance anyway? The estimate is $1300 (almost the blue book value of his car). Can I offer either to pay mechanic directly for repairs at $1300 or a cash settlement for like $800 that he could do whatever with? Is that legal? He could drive his dented car just fine and might go for this I think.

    Also, he reported it to my State Farm even though I asked him to get an estimate and let me know. How do I tell State Farm that this didn't happen so my rates don't go up anyway if I pay out of pocket.

    (Deductible is $500)

    submitted by /u/formerfatboys
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    Renting a car without personal insurance

    Posted: 04 Dec 2017 06:32 PM PST

    I'm a scooter driver with motorcycle insurance and from time to time I need to rent a car for work or just to get out of town (LA Resident). I want to make sure that I have the best coverage I can get. I've been looking at renting from Turo as well as standard rental agencies and I'm hoping someone can advise me as to what I need to consider when purchasing rental insurance.

    Here is the description of Turo's premium insurance:https://support.turo.com/hc/en-us/articles/203990610-I-d-like-a-detailed-explanation-of-insurance-and-protection-provisions

    My credit card covers collision:https://www.capitalone.com/credit-cards/blog/rental-car-insurance/

    Thank!s!

    submitted by /u/Wozezeka
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    Eligibility Question

    Posted: 04 Dec 2017 05:18 PM PST

    Hey guys, quick (hopefully simple) question. I am applying for marketplace coverage as I am not eligible for health insurance through my job because I am not full time yet. My wife is full time and has health insurance options through her job but she is 23 and still on her mother's plan. So it's "possible" for me to become eligible but I am not eligible as it stands right now.

    So can I answer no to the "currently eligible for health coverage through a job (even a spouse)" question?

    submitted by /u/Bazinga0077
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    Hit by someone in a rental car...they did not purchase liability

    Posted: 04 Dec 2017 05:18 PM PST

    So long story short a guy rear ended my wife and come to find out he did not purchase the liability insurance from Enterprise. I called and spoke with the guy and he does not have personal insurance as he does not have a vehicle. My wife ended up taking an ambulance and spending some time in the ER. (She is pregnant)

    This all happened in Texas.

    What recourse do I have assuming Enterprise does not cover the incident?

    How can a rental car agency not require at least liability insurance when it is state law?

    submitted by /u/brunograf
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    My girlfriend is in a lot of pain in her stomach, but her mom refuses to give her medical card or insurance card

    Posted: 04 Dec 2017 04:48 PM PST

    My girlfriend is in a lot of pain in her stomach, but her mom refuses to give her medical card or insurance card (which ever one it is under obama care) Can she still go to the Doctor and get help without this and if so what will happen. USA

    submitted by /u/Jopocalypse_N0W
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    Car insurance question?

    Posted: 04 Dec 2017 02:51 PM PST

    I have an insurance situation, and I cannot figure out what I should do. I have a 2005 with 180,000 miles with minor body damage (broken grill, and missing a fog light.) I have carried full coverage insurance since I have got it. Full coverage is 128 a month with a 1000 dollar deductible. I can go down to liability and pay only 70 dollars a month. Would this be smart to do? With the car being so old would the insurance even pay much? The car is paid off by the way, with no leans. Just needing some input. I just don't want to throw away extra money on full coverage if I won't get much if I do wreck it.

    submitted by /u/RiverGambler
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    Helping friend with insurance after car accident. Need advice on next steps.

    Posted: 04 Dec 2017 02:48 PM PST

    got in an accident in my grandmothers car

    Posted: 04 Dec 2017 02:29 PM PST

    I was driving my grandmothers car and rear ended someone. their car seems to be okay but my grandmothers car is totaled. I feel disgusted with myself and extremely guilty. I just feel like a total idiot. I am poor and have liability only insurance. my grandmother said she would let her insurance take care of it. I wish I had the money and coverage to pay for and take care of all of it. but the fact is I dont. im grateful to have such a loving and forgiving grand,other. what I want to know is, what penalties do I face? insurance and DMV-wise?

    submitted by /u/Softwareguy010
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    Got hit, no witnesses or police report. What do?

    Posted: 04 Dec 2017 10:39 AM PST

    Someone hit me, minor damage sustained on my car, but I filed a claim nonetheless. She had two adults with her. Policeman was nearby, I thought he saw the accident, and he helped us exchange information.

    Other party's insurance is denying to pay my damages, claiming there are no witnesses or a police report to support my side of the story. Apparently the policeman didn't file a report and the other driver says it's my fault. Plus she has two people to "confirm" her side. So it's a he said, she said. Literally. I am beyond frustrated and upset, but that's not the issue.

    My damages are, again, minor. Maybe a total of $250. I can cover that myself.

    My question is this, in this situation, is it better to have the damages covered by my insurance or just get it over with out of pocket? If I choose to not go through the hassle of insurance, would that mean that I am somehow accepting fault? I live in MI, so it's a no-fault state apparently, not sure if that's relevant.

    What's my best course of action from here on?

    submitted by /u/juj123515
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    Got Rear Ended, First Claim Advice

    Posted: 04 Dec 2017 04:15 AM PST

    Hello,

    I drive an 04' Hyundai Elantra. I got rear ended the other day and based on my brother in laws estimate (he's an estimator), my car is going to be totaled. I called the insurance and filed a claim and awaited the call back Friday. I missed the call so i called the lady back, no answer, left a voicemail. Was getting close to end of the work day and no call back. Called her 2 more times and left a voicemail. Missed her call by a second and immediately called her back and she did not answer so i proceeded to call her about 12 times. Never got an answer so I expect to talk to her today. What should I be saying and expecting? New to this so do not want to get ripped off. I hit my head pretty good as well so I am planning to make an injury claim. Thanks for any advice! O a police report was filed as well.

    submitted by /u/edlovereze
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    Insurance Company Wants to Total my Vehicle

    Posted: 04 Dec 2017 09:18 AM PST

    Hey all, our vehicle was recently in an accident. After taking the car to a shop, my insurance company contacted me and told me that my vehicle was declared a total loss (in my state, that threshold is 75%).

    I asked to see the estimate for the repairs and the estimated repair value was just under 75%, around 73.5%. I contacted the insurance company and asked, since it wasn't yet at 75%, if they could cut me a check for that repair amount (73.5%) minus my $500 deductible. I explained that I don't want the vehicle totaled, since it is not yet at that 75% mark, and that I would accept the payout and take responsibility for any additional expenses on my own, so that if it does end up costing more than 75%, that risk is on me and not on them.

    They are not working with me and have not really seemed willing to do this, though no one has really given me a firm no either. They just keep saying that it is going to be above 75%, so it will eventually be a total loss, even though the estimate (from a shop they picked out) is not yet there.

    Do you think what I am asking is reasonable and that I have a chance, or should I give up?

    Alternatively, I suppose if I can prove that their valuation for my vehicle is too low (which I have found numerous comps that would increase the valuation), or if I were to take it to a different shop and get a second opinion on the estimate, that might give me enough financial wiggle room to bring the estimate lower than 73.5%.

    What are your thoughts? Do I have an argument here to ask them not to total the vehicle? Thanks in advance for your time.

    submitted by /u/RedeemedbyX
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    Insurance appeal (Georgia)

    Posted: 04 Dec 2017 12:48 PM PST

    Hey all. I have a feeling that I'm going to have to learn my lesson the hard (expensive) way but I thought it would be worth it to run my situation past you guys first. I appreciate all thoughts and suggestions.

    I got a dental bone graft on July 29th 2016. My surgeon's office ensured me that it was covered by my insurance (I now know my first mistake was not checking with insurance myself) BlueCross BlueShield (BCBS). I paid ~$4500 for anaestesia and other items the office said was not covered by my insurance. They filed a claim with BCBS on September 16h 2016 and the claim was denied because this service required preauthorization. The surgeon's office later appealed the denial and was again rejected on March 1st due to lack od preauthorization. The surgeon's office appealed once more and I was denied on March 15th. BCBS rejected the claim stating that it is not a covered expense under my plan.

    I am covered by my father's insurance plan so they were calling him with this information until the surgeon's office recently called me and asked for me to pay the balance. I had been kept out of the loop and thought everything was square for over a year.

    That's the short of it. I have plenty more information if it would help anyone. My question is; is it even worth it to try and write an appeal to BCBS? It's well over the 140 day period that they legally have to give me since I didn't find out until recently that I still owed this amount.

    I truly appreciate any and all advice. Thanks for your time!

    submitted by /u/thirstypuddle
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    Personal Malpractice/Liability Insurance for Doctors Beyond What Hospital/Employer Carries (Arizona)

    Posted: 04 Dec 2017 11:07 AM PST

    My wife is a doctor who works for a large hospital in Arizona. She is wants to protect herself and her/our property if she were to get sued. We understand that the hospital carries malpractice insurance on her behalf, but is personal malpractice insurance most doctors carry? Is this a product that insurance companies offer?

    submitted by /u/sirhoracedarwin
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    Lending a leased car to a friend or family member?

    Posted: 04 Dec 2017 10:43 AM PST

    Is it OK to allow a friend or family member to borrow a car that is leased?

    We are located in Florida.

    submitted by /u/sourlens
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    Purchasing private Short Term Disability

    Posted: 04 Dec 2017 10:19 AM PST

    Hi Everyone - I am planning for trying to conceive next year and my employer offers no Short Term Disability - do any of you had a similar experience and/or can offer some advice and companies who wrote your policy?

    submitted by /u/westsidegerman
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    Xpost from r/legaladvice: Employer wants me to do electrical work. I'm an IT guy

    Posted: 04 Dec 2017 09:55 AM PST

    In the great state of Illinois, in Kane County if it matters, I have been asked by my employer to bypass ballasts in 277v fluorescent fixtures so that we can use non-ballast LED tubes.

    I am an IT guy. I have zero education in electrical work, and in fact I am mostly afraid of electricity due to some unpleasant experiences that I have had in the past.

    The work is pretty simple: make sure the light is off, Cut those wires, screw a wirenut onto those other wires, put it all back together.

    I have however, due to a lack of familiarity and not being in practice with that job skill set, cut through a hot 277v line (no injury, just a now worthless set of wire cutters) and plugged "ballast required" bulbs into a non-ballasted fixture. (No injury there either, but that typically results in shattered bulbs and with my face right up in it, could have resulted in lost vision).

    Despite those occurrences, I finished the first office of four. My wife is insistent that I cease immediately, that not only is my health in jeopardy, but that we would be personally liable for any accidents that happen as a result of my work whether to me or someone else after the fact as I am doing work for which I am neither licensed nor trained. And the company's insurance almost certainly does not cover this situation for either my injury or someone else's since I am not an electrician.

    HR is aware I have no skill in this regard, and has observed me taking apart the lights in her office, so nothing is immediately coming to her, or if it is, it's not moving her to action.

    I guess my question is "what is my liability here?" If I am to continue this work, what do I need to secure from my employer? Can my employer even protect me from other people who might decide to sue me since I was the last person to touch those lights?

    submitted by /u/Imtakenforgranite
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    Tiny car insurance payout. Cash or no?

    Posted: 04 Dec 2017 09:13 AM PST

    So here's the background. About a year ago I hit a deer with my truck. It messed up my bumper a bit put a good sized scratch down the side of my panel and messed up my alignment. I decided to take this opportunity to replace it with a steel bumper replacement using some of the money I expected from the settlement, but that's fairly irrelevant. Progressive landed on a number about $40 over my $500 deductible. (How convenient) after trying to get them to make a more fair offer they bumped it to around $60 after deductible. (Yippee)

    So my question is regarding my future premiums. Since the claim shows to anyone looking that I did not cash the payout. Am I better off just leaving it as is or should I just cash it? Will it make any difference? I don't need the money but 60 bucks is 60 bucks if it's all the same anyway. However, I'd rather my record look a little better if that would be the case. I appreciate any light y'all can shed, thanks.

    submitted by /u/bozo_ze_clown
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    Premium increases after an at fault auto accident

    Posted: 04 Dec 2017 08:21 AM PST

    I was recently in an accident in which I was deemed at fault. Both cars were a total loss. There were no injuries however.

    I am in the process of purchasing a new car. My insurance company cannot tell me how much my premium will increase until they renew my policy in a few months (I am certain it will).

    How much my premium increases will have an impact on how much I can afford to finance when I purchase my new car. I have never had an at-fault accident, have a clean driving record, and have NO IDEA what to expect.

    Any advice, anecdotal experience, or professional advice about what I should be prepared for financially is much appreciated.

    submitted by /u/jessieomc
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    Question about Freelance Clients and Insurance

    Posted: 04 Dec 2017 04:10 AM PST

    Hi guys, so I spent the day last week shopping for health insurance. It turns out that I've got to phone my state department to see if I'm applicable for Medicare. I was reluctant but they say that in order to continue I've got to do it.

    So my question is, are they going to reach out to my clients if I provide my billings to them? I work freelance and get 1099-MISC's from them. Is that all I'll need to provide, as far as dealing with them goes?

    Please let me know if I can elaborate and thanks in advance.

    submitted by /u/myroflmao
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    Home Owners Insurance- Roof Replacement

    Posted: 04 Dec 2017 07:25 AM PST

    So I live in southern Indiana and we have had a series of storms come through which had caused some significant hail damage the last couple of weeks.

    I noticed some shingles that have flown from roof and I decided to look into it a bit further. After further inspection and quote from two different roofers in my area, I opened a claim with my Insurance company All-State. I had recently just switched to All-State because of a friend of mine's father opened up a Branch. Being the friend that I am, I decided to switch from State-Farm because there was some promise of saving if bundling my home insurance and auto with All-State.

    Fast forward to this past Friday and I have an All-State inspection done and the inspector/adjuster basically totals out a new roof for me and provides an accurate replacement cost to provide for a full roof repair under my policy because of hail damage.

    One MAJOR catch, however, my new policy with All-State didn't cover the depreciation in the roof and had an adjustment in coverage so I was out the depreciation cost...Nearly 7k!.

    My question is this, with my previous policy I had full coverage for a roof replacement, plus the additional depreciation cost after completion of a new roof. I was never aware/informed that with my new All-State policy I was only partially covered. I thought I had an "apples-to-apples" coverage. This was never disclosed to me during the duration of the negotiation with my all-state agent. Frankly, I am pretty pissed, I feel like I got jibbed.

    Do I have any negotiating rights here? This is borderline fraud, by not conveying to the policyholder their lapse in coverage. Any insights of what I can do would be greatly appreciated.

    submitted by /u/Ardvarksauce676
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