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    Thursday, April 2, 2020

    Express scripts forcing us to use mail order for insulin, but is now triple what we pay in pharmacy? Insurance

    Express scripts forcing us to use mail order for insulin, but is now triple what we pay in pharmacy? Insurance


    Express scripts forcing us to use mail order for insulin, but is now triple what we pay in pharmacy?

    Posted: 01 Apr 2020 12:09 PM PDT

    We normally pay $25/month with the manufacturer copay card, now Express scripts is forcing us to go to mail order and pay $225 for a 3 month supply.
    What can we even do? The only reason we could afford the insulin now, was because of the manufacturer copay card. Now, Express scripts refuses to use it, so we have to pay $225 or not get it at all. I know it's still cheap, but with the virus happening, I'm the only one working because she is high risk.

    Anyone know if there is any way around this?

    submitted by /u/DarthScab
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    How does Gap Insurance work?

    Posted: 01 Apr 2020 10:19 PM PDT

    State of Georgia. I have Cigna Open Access Network health insurance, so I can go to any doctor that I choose. I also have Gap insurance through them, as well. It is supposed to help me pay the deductible (doesn't include doctor visits) up to $2,000. When does this get paid? Is it reimbursed after I pay the doctor or how does it work? Never had it before and all of the info is vague. My deductible for the insurance is $2,500 and $4,500 max out of pocket.

    submitted by /u/jmr106
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    I'm confused about pre-existing conditions in healthcare.

    Posted: 01 Apr 2020 09:56 PM PDT

    Every where I google there's articles and pages stating health insurance companies can no longer deny medical service due to pre-existing conditions. But whenever I go to sites like BCBS or United Healthcare I look though the plans and list they won't cover pre-existing conditions. I'm super confused, is there a loophole?

    I quit my crappy retail job a few months ago and had health insurance through them. I ended up in the hospital because a kidney stone was blocking passage from kidney to bladder, there it was discovered I only have 1 kidney. Now I have no health insurance, and my new job does not have health benefits because I'm a contractor. damn....From Arizona...

    submitted by /u/aureliusthesun
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    Am I eligible to apply for unemployment insurance?

    Posted: 01 Apr 2020 08:16 AM PDT

    So I used to drive Uber and Lyft. I had to stop because there was no demand due to the coronavirus.

    I signed up for InstaCart and did it for a week, but now I don't feel it's worth it to put myself at risk shopping in crowded stores all day. Am I still eligible to apply for unemployment insurance even though I did InstaCart for a week?

    Thanks

    Location is NYC

    submitted by /u/hipster_rebbe
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    College kid thinking about getting Florida 6-20 All Lines License, advice?

    Posted: 01 Apr 2020 08:00 PM PDT

    As the title says I am considering getting a 6-20 All Lines license in Florida. I am currently a Florida resident and college student majoring in international relations and minoring in economics. I've worked in construction since I was a teen (dad's a contractor) and I would like to possibly get into adjusting as a career and from the research I've done the 3-20 seems to be the first step.

    I'm currently looking at the adjusterpro.com 6-20 pre-licensing course ($300) and wondered if anyone has experience with it? Is this worthwhile? I'm 21 and don't really have any experience in insurance and frankly I have zero office experience. Would it even be worth my time or should I wait until after I graduate? All advice is appreciated, thanks!

    submitted by /u/pm_me_HiraiMomo_pics
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    At-fault driver's insurance/claim agent is calling me for a rear end accident.

    Posted: 01 Apr 2020 04:07 PM PDT

    I live in Michigan and I was in a rear end collision past Sunday. I got hit and it was the driver's fault completely and she received a ticket when the cops came and made a report. I already called my insurance and my agent told me to report a mini-tort claim to get her insurance to pay for my damage because she was completely at-fault. The max I can receive is from her insurance is $1,000 because I live in a no-fault insurance state and I do not have collision coverage on my policy. I will be filling the claim once I get my police report in and my car estimate. I received a voicemail from her claim agent last night from her insurance company and left me a voice mail to call her back and I got a claim number from her? Would I need to give her my statement? The police report has my statement and my agent told me not to say anything back and do not give any statements to her. Is the other insurance agency trying to help (probably not) or trying something fishy to avoid this? Maybe, I'm just over exaggerating? Any help from you guys?

    submitted by /u/SOLODOLOGUY
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    Condo Association insurance problems

    Posted: 01 Apr 2020 11:59 AM PDT

    I own a condo in Virginia that had a pipe burst in December leading to flooding my basement and all the fun that comes with it. I have USAA for homeowners insurance so I started the claim process. Once USAA reviewed my association by laws, they told me to file the claim with the association because the damages and repair would be covered by the master carrier policy. USAA also paid me $5000 (master carrier deductible).

    About one month later I received a letter from the law office that represents my association. A denial of my claim was stated with a long list of reasons. USAA told me I would be covered under my policy but only if the master carrier issued the denial.

    At this point the master carrier is all but refusing to issue a denial and I was told a second letter from the law office is being drafted.

    Has anyone dealt with an issue like this? Or with USAA when it comes to claims?

    submitted by /u/burnRTP
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    Xactimate/xactanalysis help

    Posted: 01 Apr 2020 05:27 PM PDT

    Started at a major, well known company as a claims examiner with zero prior experience. For whatever reason, I can't make these 2 systems click in my head during training. Anyone have any resources to learn them?

    submitted by /u/Anglo-american-man
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    Newbie to USA car insurance - Is it worth using insurance for minor collision damage?

    Posted: 01 Apr 2020 02:46 PM PDT

    I damaged the side mirror on my car and another car and am trying to work out whether it is better to file a claim and get Geico to cover it or just pay for it myself.

    I called Geico and as I understood it, they said it would come under property insurance for the other persons car. Does that sound correct?

    The deductible for damage to another person's property is about $100 and I would use collision cover for mine which is $200.

    I think I can get a second hand mirror and get it replaced for about 200 for my own car. And was quoted 300-500 for the other person's car.

    I think it's more cost effective to go with insurance, in the least for the other car, but will our rates go up? Is it worth it? Will I be penalised later with increased premiums? I tried to speak through this with the agent but she said she would have to file a claim to be able to advise me and I don't want to create a situation where I get some kind of black mark, we are pay even more insurance than currently!

    submitted by /u/Efficient-classic
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    Accident Bodily Injury Claim After Settlement

    Posted: 01 Apr 2020 08:34 AM PDT

    I rear ended another vehicle at slow speeds back in November. All parties were fine with minor paint transfer to both vehicle.

    A few weeks later I receive phone call from my insurance stating the other party has submitted an injury claim. I then get a phone call stating that the injury claim had been settled.

    Last week I receive a phone call/letter from my insurance representative stating that the other party has acquired a lawyer stating that my insurance "settlement is not valid." Their attorney has indicated that he instead may file a lawsuit.

    My question is what can happen here? The other party already signed and settled with back in November, but is now 4 months later squiring an attorney stating that the initial settlement was not valid.

    submitted by /u/ebsq17
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    Are legitimate bonuses typically counted as part of payroll basis for WC/GL?

    Posted: 01 Apr 2020 10:11 AM PDT

    My construction company has a policy where, if a project finishes ahead of schedule, the field crew gets 50% of the remaining labor budget. I am concerned that GL/WC carriers will say this is part of the payroll basis, and slap me with a hefty bill at my next audit.

    My contention would be that there is no additional risk taken when a bonus is paid, and that a charge would therefore be unfair. I can see why their response might be "if we let that slide, everyone would just pay their workers 100% 'bonuses', which also isn't fair". But these payments are legitimately bonuses - I'm playing on the level, and I am sure I can produce records that would prove it.

    I've asked my insurance agent about this, but he never seems to be able to give me a clear answer. I've tried reading the policy, but can't find anything related to this. What is a typical range of outcomes here? Do I have a chance of getting this to work out in my favor if I just keep very clear, comprehensive records?

    This is in New York City

    submitted by /u/GiantPineapple
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    After appealing health insurance claim

    Posted: 01 Apr 2020 12:31 PM PDT

    Hello,

    I appealed my health insurance claim around end of Feb. They said 30 calendar days to review the appeal which was about a week ago. I sent them a follow up after 30 days have passed and was told that they are still reviewing it.

    Is there any regulation and laws regarding reviewing the appeal such as how long they could review and when they have to notify the result? Or could they take as long as they want even though they told me 30 days?

    CA

    Thank you!

    submitted by /u/Ciris31
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    Hit and Run, California

    Posted: 01 Apr 2020 11:24 AM PDT

    Got hit and run in the beginning of the month, police report came I got all the information license plate,vin make and model.... car owner not the driver that caused this .... no insurance on the report ... how can I go about figuring out if owner has car insurance ? thank you

    submitted by /u/bszb
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    Medical claim insurance processor

    Posted: 01 Apr 2020 10:49 AM PDT

    Can someone explain what exactly a medical claim insurance processor does? Thanks.

    submitted by /u/EasternInside
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    Will I be Refunded for my Travel Insurance if the Cruise was Canceled?

    Posted: 01 Apr 2020 05:51 AM PDT

    So my cruise was canceled by the cruise line due to the virus. I will be refunded for the entire cruise via my original form of payment, but I didn't see anything that stated that I would be refunded for the travel insurance that I purchased... Will I? I obviously did not use the travel insurance.

    submitted by /u/alexmeowwood
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    I've conceptualised an insurance product that is designed to not pay out 95% of the claims. I don't care about being judged.. How do I get it out of the concept stage into next stage. What is the next stage?

    Posted: 01 Apr 2020 04:45 PM PDT

    I've thought of a niche insurance concept that can be sold as an add on to most vehicle policies. And most people would take it. It's designed to be cheap and the max payout is capped. Where do I start?

    submitted by /u/ChillainManila
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    Cross-posting in hopes of some good answers.

    Posted: 01 Apr 2020 07:48 AM PDT

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