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    Tuesday, November 6, 2018

    Heath Insurance Retroactively Cancelled? Insurance

    Heath Insurance Retroactively Cancelled? Insurance


    Heath Insurance Retroactively Cancelled?

    Posted: 05 Nov 2018 02:40 PM PST

    On Saturday I received 2 letters from my health insurance company. The first was an EOB denying labwork performed on 09/26/18 due to "Member not eligible on date of service". The second letter was was an official notification that my health coverage has been cancelled effective 09/01/2018. This came as a complete surprise.

    Some backstory- Mid-August I left my job at a small company who provided health insurance through Optima. After quitting I set up an account for coverage through COBRA. My health insurance for August had already been completely paid for.

    On 9/1/18 my COBRA account was paid for the month of September. A few days after that, I attempted to fill a prescription and was told I had no insurance. I contacted Optima, who claimed they had not received any information regarding COBRA coverage. I called the COBRA company, who provided multiple documented submissions to Optima regarding setting up my account. Over the next week, my COBRA company continued to go back and for with Optima, each time Optima claiming they didn't receive anything. Finally, the COBRA company refused to get off of the phone while the information was submitted and waited for Optima to receive it, and Surprise! Optima received it just fine when COBRA was on the phone.

    Since then, everything has been great. I have had multiple drs appts, prescription refills, etc completed with no issues. I was issued a new insurance card from Optima with a start date of 9/1/18. I have received every EOB up until now completely approved (including part of the visit on 9/26/18 which is now being denied). I have continued to pay for COBRA every month with no problems.

    Since I received cancellation letter on Saturday, I couldn't call until today. Optima initially claimed that I never had insurance after 8/31/18. After explaining that I received a new card, had multiple EOBs in hand with coverage paid for, they suddenly changed their story. Now they are saying that COBRA notified them on Oct 18th to retroactively cancel my insurance. So I contact COBRA. They were taken completely by surprise and have no record of contacting Optima regarding cancelling my service. They promise to investigate.

    I call Optima back and explain that COBRA did not cancel my insurance. The representative I spoke to this time was completely nasty to me. She claimed that Optima doesn't "have anything to do with COBRA" and that my "previous employer called them and told them they didn't want to offer COBRA". This made no sense whatsoever. When I pressed on the fact that 1. I had insurance coverage up until (apparently) the 18th and 2. Optima had paid for things between 9/1-10/18 with no problem, the representative actually told me that "Optima pays for things in good faith then verifies you are eligible for insurance after the fact. Now Optima is going to come after you for all of the money they spent on you when you didn't actually have coverage". This was so beyond ridiculous that I just gave up on the conversation. (When was the last time you heard of an insurance company altruistically paying for things?!?!

    I followed up with my COBRA company, just to verify that my company hadn't stopped offering COBRA. Not only did they confirm that they were still offering COBRA, but they pointed out that even if they did, it couldn't work retroactively. They have promised to reach out to Optima, but I know from the past that Optima will be incredibly difficult.

    What can I do in this situation? How can Optima retroactively cancel my insurance? Also, if they were notified 10/18, why did it take until 11/3 to send a letter notifying me? I still do not have any idea who supposedly notified them to cancel the policy. Shouldn't they legally have to provide that information? It seems really crazy that they can just claim that "somebody" cancelled the insurance and not have to provide any information on who that someone was or whether they had the authority to actually cancel the insurance. Everything about Optima has been really sketchy and every time I reach out to them they claim they can't speak to me. (When I was initially enrolling they claimed they could only speak to by COBRA company, now the latest representative claimed that since I'm not enrolled, they can't talk to me at all). Please- any advice would be greatly appreciated!

    submitted by /u/Ryyn
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    Why Cant I purchase both Uninsured motorist and Collision coverage from Geico?

    Posted: 05 Nov 2018 10:04 PM PST

    The site doesn't seem to allow me to purchase both when I try to add them. Other sites allow me to, is there a reason for this?

    submitted by /u/bonkers555
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    In Wisconsin, what should I do if my employer's health insurance isn't cutting it? Can I buy more insurance on my own?

    Posted: 05 Nov 2018 09:19 PM PST

    Something I've always wondered. If I changed jobs to a company with poor health insurance can I do anything about that?

    submitted by /u/backlogplayer
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    Paid for a month of health insurance for newborn but they won't cover the first 30 days

    Posted: 05 Nov 2018 01:37 PM PST

    Texas.

    My son was born in February and I added him to my policy (United Healthcare) right away. My wife has another policy (Blue Cross Blue shield) that's just her.

    We filed everything with UHC and everything seemed fine for the first few months. By May we find out UHC rescinded claims for the first 30 days and stated that BCBS is the primary insurance according to some law.

    Son had a doctor appointment on the 31st day and neither company wants to be responsible (this is a secondary issue).

    So I had withholdings on my two February paychecks that reflected adding my son. But they aren't covering anything for the first month so why should I have paid them?

    Am I entitled to get that money back, and if so how should I go about it?

    submitted by /u/soulstonedomg
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    Trapped between choosing to insure myself or my future child - help!

    Posted: 05 Nov 2018 10:20 PM PST

    Like pretty much all of America, I'm finding myself stuck in terms of health insurance. I'm a 30f who is currently expecting and due in May. I have a variety of preexisting conditions that require regular care but an currently doing relatively well. I'm covered under Cobra coverage for now and husband is uninsured, but employer does offer laughable insurance.

    We figured we would just swap to a marketplace insurance plan next year to make sure the baby was covered but all we have are HMO plans that don't cover a single OB in town much less my specialists so that's out for me as I kiiinda have to deliver this kid.

    AFAIK we can't get coverage for just the kid and we make too much to qualify for assistance programs but not enough to be able to afford husbands premiums+bills. So the best we can figure is for 2019 for me to stay under my COBRA care and pay out of pocket for baby's appts for rest of 2019. Assuming a healthy baby I think this is the most logical course of action as we'd have to spend over $600/ month before it would be cheaper to swap to my husband's insurance.

    Am I missing something? Does anyone have any extra advice or suggestions? The thought of having an uninsured kid for a few months is terrifying but I think also the most logical.

    Details :

    1. I am currently covered through Cobra coverage until 2021 through my previous employer. $700/month premium

    2. The only marketplace insurance available in my area is from Ambetter which I hear is terrible and also has virtually no local providers (most are 45 minutes away and even then are notoriously awful). $500-700/month premiums and no local OBGYN or high risk OB at all.

    3. My husband has access to insurance through his employer at $1200/month for family or $700/month for him child.

    Thanks in advance!

    submitted by /u/ImAnalyzingYou
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    NY - can I put my child in NY Child Health Plus even if my employer offers family insurance?

    Posted: 05 Nov 2018 09:43 PM PST

    I am willing to pay based on income for the state children's health insurance.

    My current insurance is a cooperative that seems to be floundering and denying things it previously covered. My biggest issue however is that my insurance doesn't do any prior authorizations.

    I can never find out if something will be covered until after I go through with it. It makes me hesitant to get some things done for myself- and I don't want that if I have a child. I'm anxious even calling an ambulance because coworkers had it denied if the insurance deemed it unnecessary later.

    I know they don't typically allow you to get this insurance if you can get it through work but I'm desperate and willing to pay separately for the piece of mind.

    Does anyone have experience with this or know who I could contact about it? I would greatly appreciate it!

    submitted by /u/punkass_book_jockey8
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    Taking my property and casualty test tomorrow

    Posted: 05 Nov 2018 07:04 AM PST

    After close to a week of study (the required 40 hrs pre-licensing education in New Jersey) I feel ready to take the test. Any advice? I am very anxious since I already have a job lined up waiting for me to pass it.

    submitted by /u/AlwaysBeClosingDoors
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    Is it possible to take yourself off someone else's plan?

    Posted: 05 Nov 2018 05:31 PM PST

    Hi.

    I'm 18. I know you can't be removed from your parent's insurance by your parents until 26.

    However: one of my parents (they're separated), my dad, is extremely abusive and I don't want him knowing about my personal medical history. If I have another plan, can I call up his company (UnitedHealthcare) and request to be removed from his insurance? If the answer is "no", what can I do?

    submitted by /u/rajaa_
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    I hit a biker

    Posted: 05 Nov 2018 12:53 PM PST

    Last week I was driving and while crossing an intersection on a green light I hit a biker (not a motorcycle) who took a red light and didn't even slow down. He was taken to the hospital with what appeared to be minor injuries. One of the first responders said that he was really really wasted. How do I get the damage on my car fixed? Can I take him to court, can I sue my insurance? What should I do?

    submitted by /u/managementcapital
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    Nationalization of P&C Insurance and regulations

    Posted: 05 Nov 2018 05:37 PM PST

    Hey everybody. Just wanted some opinions on whether or not nationalizing things like auto and home insurance would benefit consumers. Also if you think these types of insurance are overly regulated or underregulated. Always nice to get different perspectives from people in the industry. Thanks for your input.

    submitted by /u/wabisabi92
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    What happens if you're hit by someone & your car has a salvage title?

    Posted: 05 Nov 2018 07:49 AM PST

    Do you get the salvage value for your repairs?

    submitted by /u/Halfawake
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    Rental Car Damage

    Posted: 05 Nov 2018 04:40 PM PST

    About 4 weeks ago I rented a Silverado pickup from a well-known rental car agency (E\prise*) in a tiny town about 200 miles from home. I managed to scratch three panels brushing up against scratchy trees (two arm-length digs through the clear coat, maybe paint as well, and a shorter/shallower one).

    Scratchy trees gonna scratch... When I returned the truck I fessed up and showed them the scratches. We did some paperwork, and I handed over $500 (my collision deductible) and my personal auto policy info.

    Fast forward to now, no claim has been filed.

    In the meantime, I've checked with my credit card for possible coverage there, since I used a card with rental damage coverage. No dice; trucks are excluded.

    I also called E\prise* in response to a letter instructing me to "file a claim". But there is no claim to file, yet. They said "oh it will take a while to get a final on the damages".

    I've also been talking with my local insurance agent. Like a good neighbor, he's been a huge help explaining what could happen with my rates. My question is not about that.

    My question concerns the conspiracy theories I have in my head right now about what's going on between the rental agency and their body shop. Among them:

    • Why is this taking so long? Is the rental agency going to charge for lost use of the vehicle?
    • How can I possibly validate what the tiny town's body shop says about the costs of repair?
    • What, if anything should I do?

    I guess I am just getting antsy. I'm fine with owning my share of responsibility, I just don't want to get to get taken advantage of.

    submitted by /u/feirnt
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    Renters Insurance for my mom

    Posted: 05 Nov 2018 12:52 PM PST

    So my brother and I bought a house for my mom to live in. Him and I own the house on paper but we wont be living there. I got home owners insurance on the house through USAA. At this point I'm unsure about if we need renters insurance. She wont be paying rent, so idk if she even counts as is a renter. But if she burns the place down is USAA going to care that she wasn't an owner? I hope that made enough sense, let me know if further clarification would be helpful.

    submitted by /u/WalkingPhoenix
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    Car should have been totaled but wasn't. Now my car is no where close to the way it was prior to being hit.

    Posted: 05 Nov 2018 03:37 PM PST

    Background: I was stopped at a red light when another driver slammed her car into mine causing a lot of damage to the rear right side of the car (2013 Civic). The initial estimate was $4,000 to repair, but upon picking it up the price at risen to $7,000, which is close to the vehicle's trade-in value on KBB.

    The bumper, quarter panel, rear passenger wheel/tire were replaced, and many other things were fixed including the floor of the car. The floor is part of the vehicles frame and was not included on the initial estimate, and I'm pretty upset because once metal is bent it will never go back to exactly the way it was. They also used an 'aftermarket' part for one of the taillights, even though I specifically told them if they're replacing a part made by Honda, then the replacement also needs to be made by Honda.

    So there was A LOT more damage to the car than they said initially, and I have noticed many issues with my car that weren't there prior to the accident. They are:

    • The interior now has a nasty chemical smell.
    • The car now pulls to the right.
    • The car rides much rougher than before. It used to be smoother than a family members car with 3x the miles, but now it is worse.
    • The steering wheel vibrates and shakes. This differs depending on speeds. It did not vibrate or shake at all before.
    • The gap between the passenger rear quarter-panel and my back windshield is not consistent, and is also much smaller than the driver side.
    • The welding under the trunk lid on the passenger side looks far different than it did before, nothing like the driver side.
    • The gap between the passenger side tail-light is not consistent anymore, and it's even touching the quarter panel in some places. The driver side tail-light has a nice 1-2mm gap all the way around it.
    • The passenger side tail light does not line up with the bumper, this is more noticeable when the trunk is open.
    • The gap between the trunk lid and the bumper is about twice as big on the driver side compared to the passenger side. This used to be constant.
    • The bumper does not line up perfectly with the quarter-panel on either side anymore.

    It kind of seems like the car should have been totaled, but the shop realized too late and ended up either skimping on parts or labor time to keep costs down.

    After the repair the car should look (and drive) exactly the way it did before, but it does not and I am very upset by this because it's the first car I bought with my own money and I've made sure to take very good care of it so far.

    I called my insurance and explained the situation and they said it was something I'd have to work out with the shop. My insurance did however say that they had not been made aware of the additional $3,000 in damages. I told them they might want to hold off on paying that until it's actually fixed.

    What are my options? I've talked to a few people and most seem to think it's never going to be the same as it was prior to the accident due to how extensive the damage was. If the accident had been my fault then I could live with it not being perfect, but I don't think it's at all unreasonable to expect my car back in identical condition to the way it was before an accident that was in no way my fault.

    submitted by /u/Simonov
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    Math problems in ARM sequence

    Posted: 05 Nov 2018 02:24 PM PST

    I'm working on ARM 54 now and have loved the math problems /s. Curious as to whether ARM 55, 56 and RMPE 352 have more math than ARM 54.

    submitted by /u/wqt00
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    Hit by a guy without a license

    Posted: 05 Nov 2018 08:17 AM PST

    About two weeks ago I got hit by a driver who was driving without a license. He was 100% at fault and told me and the police he had full coverage. When I called his insurance company today they told me that since he was driving without a license that my claim was denied because it was the equivalent of driving uninsured. Is this accurate? I live in Illinois if that makes any differences. Thanks.

    submitted by /u/iitzguardian
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    Improper billing by provider?

    Posted: 05 Nov 2018 06:38 AM PST

    I recently started seeing an Allergist to get my allergies under control. In total I have seen her 4 times including one intake visit where they did allergy testing and, three times for shots. However, they have now billed my medical insurance 7 times, each with a different visit date. Subsequently, they also charged me a co-pay for each of those seven visits. I'm under the impression they did this because it became clear to them after my first to visits that the insurance wasn't going to cover treatment in the manor they were providing it and they were trying to submit the claim in order for them to get paid what they think they should be. Should I report this to the insurance company? I'm torn, because I understand my doctor wants and needs to get paid, but I'm not cool with paying more in the co-pays, and I feel like it is overall a bit sketch. Also, I would rather make things go south with my doc, and I also don't want to some how become responsible for paying the bill myself if I report it to the insurance company and they decide that treatment isn't covered. What should I do?

    submitted by /u/StevenTiberius
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    Non-owner car insurance

    Posted: 05 Nov 2018 01:41 PM PST

    Hi, recently I sold my car and wanted to cancel Geico. The agent told me to keep about $60 non-owner car insurace (my car insurance liability, was about 105$ per month). She told me that insurance like credit history and if i cancel it now, in future my rate goes up. What should i do? Keep non owner insurance? Does it worth? Im student, and im not sure will I buy a car next 6 months or not. Can next car insurance go up more than 50%, if i cancel it now? Looks like 60$ is about 50 % of my insurance. Thanks

    submitted by /u/dodoc18
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    Hit by someone without coverage

    Posted: 05 Nov 2018 12:49 PM PST

    I was parked and a guy backing out of parking lot rear ended me. We exchange info and file police report. I contact his insurance and they say his policy is not current so they wont cover me. I can file a claim with my insurance and hope this guy gives me the deductible but that also raises my rates.

    Do I have any options here? My car was stationary and theres no dispute over the fault in this, however i do live in a no fault state

    submitted by /u/Hawk_fever2
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    Car insurance varying in price by the area to which it is issued.

    Posted: 05 Nov 2018 04:30 PM PST

    Is it any kind of a crime to buy a 1/50th acre plot of land in bum crunch nowhere Alaska, or something, so you can register the vehicle there while actually living in a big city and saving about 50% on auto insurance (which would pay for the land in 1/5th of a year just by doing nothing but travel there once)? Meanwhile you would save buko dollars on insurance.

    submitted by /u/Pumpdawg88
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    Do insurance companies have clauses for mass casualty events?

    Posted: 05 Nov 2018 08:56 AM PST

    Life insurance seems to only work if people die at an expected rate so companies pay out much less than they take in. Do you have examples of auto, life, or mortgage insurance companies not paying out due to mass casualty events or natural disasters? I would think these companies have some kind of clauses that would prevent them from paying out if enough people are affected.

    Edit: Thanks all for the answers. Looking up on my own about reinsurance and state guaranty funding.

    submitted by /u/rtanaka6
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    Hit a Deer

    Posted: 05 Nov 2018 07:51 AM PST

    Morning, hit a deer over the weekend and having a local Toyota dealership repair the damages. I have Geico, I just want to make sure I don't get screwed over or leave anything on the table. So far I'm getting my vehicle towed to the dealership and Geico should estimate damages tomorrow. Any help/tips are greatly appreciated. Enjoy your day!

    submitted by /u/cixelsydmai
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    City garbage truck hit my car!

    Posted: 05 Nov 2018 03:14 PM PST

    Yes, you read it right. I work for State Farm, I was parked at work, around 11a my boss comes to my office to tell me a garbage truck from the city hit my car. Apparently, the driver did not pay close enough attention to the arm (grabby arm comes out to life cans up) and drove right into the side of my car w/ the arm. Damage is extensive on the drivers side back area. My back door is completly sealed shut by metal and severe damage to the gas tank area.

    My wife and I just finished paying off the car last year. I am so worried the city is going to come back with lawyers/insurance adjusters who play dirty and going to offer me a measley 2-3k for my 2012 Kia Sou. I've looked and around my area, 2012 Kia Souls are around $6k. This is more managaable.

    My main questions....should i be reaching out to possible lawyers? Should I expect a bumpy road since I'm working with the city? Should I be asking for more?! I got a rental car, currently paying for the rental car out of my own pocket...but I am going to make sure they take over the billing and they reimburse me for any costs I've put down so far.

    I know the claims process but this is so muich bigger.I've heard some cities Self-Insure and that can be even worse...any guidence at all?! Thank you!

    submitted by /u/fayfromsf4919
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    Got rear-ended, will reporting to my insurance (not filing a claim) raise my rates?

    Posted: 05 Nov 2018 11:26 AM PST

    First accident, I am planning to file a claim with the at fault driver's insurance. I read on google that I am supposed to report that I had an accident to my insurance, but would that raise my insurance rates?

    submitted by /u/xxkxsx
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    Hit by a car and losing parent's insurance soon

    Posted: 05 Nov 2018 11:03 AM PST

    Hi guys, So I'm 25 rn, turning 26 near the end of December. I was hit by a car(hit-and-run, haven't caught him) at the end of August, breaking my collarbone and getting a concussion when I landed. The bills have not been too bad so far and I am recovering okay I guess. My collarbone is basically healed and I am doing physical therapy on it at the moment. I was supposed to do 8-10 weeks but insurance only approved about 6 weeks at this point. I have a $25 copay per session so the cost out of pocket without insurance would probably be a lot. On top of that, my bigger worry is that the concussion has not really gone away. I can't get up too fast and need to lay down into bed slowly or the room will start spinning (it can spin even if I do that). Went to a trauma clinic and the doctor said it doesn't sound too bad for a concussion. I will be seeing a neurologist in the next few days for a second opinion and hopefully a closer look. I'm worried if I have setbacks with my collarbone or lingering issues with the concussion, I won't be able to get it looked at. I should probably go back eventually to get cleared as well so I wouldn't be able to do that. I'm pretty dumb about healthcare and don't understand it all that much. What are my options here?

    P.S. I live in Chicago if that makes any difference.

    TLDR: Hit by car, losing insurance at end of year, will need to see doctors later on, options?

    Thank you in advance.

    submitted by /u/BusinessDinner
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