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    Thursday, May 14, 2020

    am I understanding american health insurance right? Insurance

    am I understanding american health insurance right? Insurance


    am I understanding american health insurance right?

    Posted: 13 May 2020 10:15 PM PDT

    Sorry if I'm asking stupid questions. I have no one around me to answer them and through googling definitions and reading plans myself I just want to make sure I understand because from what I understand (and I could be getting all of this wrong) I don't get what I'd be paying for or how it ends up being worth it.

    1. So for a plan, you have a deductible. If your deductible is 7k, for example, you have to pay 7K out of pocket for services BEFORE you're covered on future services. So I'd have to like break my arm x amount times for like the NEXT time to be free?
    2. So you're paying out of pocket until then, essentially. So why is your OOP max a different thing. Is it because your work can lower your deductible for you but your OOP max remains the same, making it so that you still have to pay through your OOP threshold to actually be covered for services?
    3. Dumbest question. Does it end up being worth it? Like does it actually even out, if you're paying hundreds of bucks a month and still paying out of pocket until you spend more than x thousand? I understand that this is like, totally dependent on the plan but I mean generally. I feel so frustrated and it genuinely feels ridiculous right now.
    submitted by /u/soursolitude
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    Probably a dumb question, forgive me. COBRA vs. Marketplace for my husband

    Posted: 13 May 2020 05:41 PM PDT

    The answer to this seems obvious to me, but I always feel the need to get second opinions on everything--especially about insurance because I am CLUELESS. Sorry it's long.

    My husband and I have always had our own insurance through our individual employers. He was laid off March 24 due to COVID19 but was supposed to go back to work in late April. His boss informed him on May 1 that his position is most likely going to be eliminated (because of the company's loss of revenue due to the virus) and he won't be asked back. It's not 100% yet, but pretty likely. His insurance was paid up to May 1 and he has been on unemployment since March 24. The HR rep sent the information for COBRA. His cost to continue on his same plan will be about $450 per month.

    I called the insurance broker that MY company uses to get his advice on getting a marketplace plan for my husband. He did a quick check on the numbers and found the plan with the least expensive premium would be about $390 per month for pretty crap coverage compared to his work plan. Biggest difference is the deductible would be $8150 as opposed to $1000 and literally the only thing covered before meeting the deductible is a visit to his PCP. (I will also be having the broker figure how much it would be to add him to my plan because I'll have to pay 100% of that out of pocket. I have a feeling it will be pricey, I have great coverage)

    Background on husband. He's 50, type 2 diabetic (he's in remission right now, maintained by medication, but he still has to go for checkups two-three times a year with lab work). He's on three prescriptions. He has had some flukey health things happen within the last three years. (blood clot that turned into a pulmonary embolism, ruptured appendix, etc.). He is getting the $600 extra per week with unemployment, so the COBRA is not a financial burden for us (right now). That's why my assumption is that going with the COBRA plan is the best option for us right now so he doesn't lose coverage.

    Everything I ever read about COBRA is "don't go with it, it's a ripoff!" But, looking at the numbers and the coverage he needs, I feel the $60 extra per month to stick with the plan he knows is worth it. Am I missing something? Also, COBRA can be cancelled at any time, right?

    submitted by /u/LucyFrugal
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    Cheapest route to insurance for new teen driver?

    Posted: 13 May 2020 05:26 PM PDT

    (Miami, FL, USA) Hi all, I'm a sophomore in high school that really wants to get my license. However, my parents flat out don't want to pay for the high insurance rates that new drivers get (male btw). I really would like to get my license, so my question is this: would it be cheaper for me to get my license ASAP and build up a good driving record, or to wait and get it later, like in college? Thanks!

    submitted by /u/jaykron
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    IRS Relaxes Normally Strict Rules To Allow Workers To Make Changes To Health Insurance Plans

    Posted: 13 May 2020 03:02 PM PDT

    Does anyone know what this means in practice for employers/employees?

    I sent it to our health insurance rep and all they could tell me was that they'd 'probably' let us to move our open enrollment period sooner in the year than normal.

    https://khn.org/morning-breakout/irs-relaxes-normally-strict-rules-to-allow-workers-to-make-changes-to-health-insurance-plans/

    https://www.nytimes.com/2020/05/12/business/employer-health-plans-coronavirus.html

    submitted by /u/qabadai
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    TX - When to cancel old auto/home insurance and why do quotes vary so much?

    Posted: 13 May 2020 04:55 PM PDT

    Hi everyone, I found a good home and auto quote after contacting some local insurance brokers. My current policies don't renew until next month. I was wondering when I should cancel them? Obviously after the new policy takes effect, but should I leave like a 1-2 week overlap? I'm curious because I read somewhere that someone switched home insurance but then their new company dropped their policy right afterwards so he had a gap on his record and I wanted to avoid this.

    Also, I reached out to several insurance brokers so I got 4 quotes from SafeCo. The weird thing was that the premiums varied so much despite having similar coverage. For home it varied from like $2000/yr to $2800/yr and for auto it varied from $2000/yr up to $3800/yr! If all the quotes are from SafeCo with the same coverage limits, why are the prices so different?

    submitted by /u/Desperta_Ferr0
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    Fake claim reported to my auto insurance, they said they denied since the car was not mine and it happened in a different state. Now I'm looking for new auto and my rates are higher because of this claim, how do I fix?

    Posted: 13 May 2020 12:15 PM PDT

    In January my auto insurance called to get a statement from me about an accident I was "involved in" in November. Someone living in California had made a claim with my insurance saying I hit them with "my" 95 Lincoln. Except I live in Arizona, I own a 17 Honda, and I haven't stepped foot in CA in over 4 years. My insurance said the person had given my name specifically as the driver, but since the car wasn't on the policy they were just going to deny the claim and I'd be fine.

    Now I'm looking for new auto/homeowners as my renewals have gone up significantly on both. I had a claim in 2018 when a coyote darted across the road that was about $7k, and two glass claims last year (front windshield smashed by rocks on the freeway about 6 weeks apart, common in AZ and I have zero deductible glass coverage).

    When looking at new auto, this fake claim is showing up on whatever insurance registry gets checked. The last person I talked to on the phone said this claim is affecting the rate I'm being given.

    This NEVER happened. How do I fix this?

    submitted by /u/jaya9581
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    Storage policy question for car

    Posted: 13 May 2020 02:56 PM PDT

    So the progressive representative told me today storage policy is only comprehensive and my state requires liability. If I do this the system automatically lets the state gov't know that I don't have liability and my state requires that so he said the state will ask me why I did this and I tell them i no longer drive.

    Then they will take the registration/plates. The representative yesterday did not tell me about informing the state. I am in IL.

    My policy ends in 6/27 anyways so the storage policy is only for a month. I am just wondering if all this stuff about state getting notified/etc happens in about a month because if I renew afterwards, I hope they don't fine/take my plates away still.

    I tried calling the DMV but atm they are closed. I will try to find out if they are actually being strict about this stuff in these times. If not I can just put my car in storage now and during renewal. But If they are still strict about this stuff, I hope I don't get fined anything for putting in storage right? Like, wouldn't I just have to turn in my plates?

    submitted by /u/Dzenis1000
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    COVID & Life Insurance

    Posted: 13 May 2020 06:20 AM PDT

    Random thought but not so random: has anyone see life insurance companies start to tighten underwriting during this pandemic? And how about for people who were diagnosed with COVID?

    Considering there's not a lot of science behind it and you have headlines range from it does nothing to oh it shortens lifespan 10 years, I was just curious what you are seeing and...asking for a friend 🤣

    submitted by /u/hTown346
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    Dental savings plan for crowns

    Posted: 13 May 2020 04:51 PM PDT

    Hello, I am looking into purchasing a dental savings/discount plan, but I am not sure if it is worth it in my situation. I don't currently have insurance, and I live in NY.

    I got a dental crown a couple months ago that I would like to replace for cosmetic reasons. There isn't anything wrong with it otherwise. I know that most insurance plans only cover crown replacements once every 5 years. Does the same apply to dental savings plans? I have looked into Cigna. Would I benefit from getting on a dental savings plan, or would I have to pay out of pocket for the whole procedure anyway since there isn't anything actually "wrong" with the crown? Thank you.

    submitted by /u/shellly_
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    Do insurance companies look at the type of license you carry to help determine primium?

    Posted: 13 May 2020 04:18 PM PDT

    I've recently found out I will be needing an occupational license. I was hoping to also call my insurance company to see if my premium could be lowered but I'm concerned this ODL could effect my chances.

    submitted by /u/TerribleAthlete0
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    Can auto insurance companies see what type of license you have ex: Occupational, CDL?

    Posted: 13 May 2020 04:11 PM PDT

    [United States,TX] I've found out that I need to get an occupational drivers license. My insurance provider (progressive) told me a couple of months ago to call around this month because I may qualify for a drop in my premium amount. I'm afraid if i call they will see that I have an occupational license and instead my premium would go up? Is this a thing??

    submitted by /u/TerribleAthlete0
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    Rate Increase Negotiable

    Posted: 13 May 2020 03:59 PM PDT

    My insurance is up for renewal and the new quote I received is $65 more a month than I was paying.

    I have been in no at fault accidents and have no tickets. I asked my broker to contact the insurance company to give an explanation on why the increase is so much and she just said that every insurance companies rates have gone up. She also suggested another insurance company which is cheaper but still $40 more a month than I'm paying now.

    My question is, is there a way to negotiate this with the insurance company directly? If I acknowledge that I am looking to change companies if the rate remains the same surely it makes more sense for them to have some of my business then none at all?

    I live in Ontario - Canada

    submitted by /u/Youdontknowjam
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    Trip Insurance?

    Posted: 13 May 2020 11:59 AM PDT

    In late February 2020, I bought domestic plane tickets (Delta), rooms (airbnb and hotel), and a rental car for a trip. Trip is June 30-July 7 2020.

    Would it be a good idea to get trip insurance to try to recoup my expenses, should I have to cancel?

    Cancellation is looking more and more likely.

    I'm in Atlanta Georgia.

    submitted by /u/astoutforallseasons
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    What are my options to seeing a doctor out of my network?

    Posted: 13 May 2020 03:22 PM PDT

    I have Medicaid(HMO) and currently trying to become a new patient at MD Anderson for new treatments not offered in my town,the issue is when I call before to get pre authorisation sent to a doctor at MD Anderson that said that it was out of network and I wouldn't be covered if I went to my first appointment.(my oncologist and PCP already sent a referral to MD Anderson to make an appointment but insurance is giving me problems)

    I will be getting a callback tomorrow from pre authorisation department but I'm wondering what my options are(plan change/new insurance/just go in medical debt)as I'm almost 100% I will get denied again as nothing has changed since my last call.

    Any advice would be appreciated as I'm not good at dealing with health insurance issues.

    submitted by /u/RJParadox
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    life insurance health exam

    Posted: 13 May 2020 03:01 PM PDT

    [deleted]


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    Am I at fault / do I have liability in the following fender bender scenario?

    Posted: 13 May 2020 02:49 PM PDT

    So, HYPOTHETICALLY...

    I am parked in a parking lot of a big box store. Parked directly opposite of me (to my rear) is a large passenger van operated by a local business. We both back out at the same time... I back out a couple feet, the van backs out much further. Our vehicles hit each other. In this scenario the van is undamaged, but my rear bumper is damaged and the repairs cost ~$150.

    Do I have the right to seek reparation from the company that owns and operates the van? OR, because I was also backing out at the same time, am I also at fault and therefore do not qualify for compensation/reparations?

    Moreover, would you guys recommend that I file a claim for this incident? I am assuming that if I do, my insurance premium would go up (hypothetically).

    submitted by /u/DiscoLove_
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    State Farm Drive Safe and Save - Good or Bad?

    Posted: 13 May 2020 02:10 PM PDT

    So, I've recently been looking for a new insurance rep and an agent from State Farm brought this up to me, and I'm a little on the fence about it. It appears to me, the current rate they offered could go down considerably after 6 months depending on what the app reads.

    The savings obviously seem great, but can any of those dings impact my rate? Or, if at the end of the six months, if the app considers me an "unsafe driver," I drive too much or something, could that cause my rate to increase upon renewal or during the term?

    I've also heard the app is sensitive when it comes to speed, braking, turning, etc. even though the agent said they use it and it's pretty lenient as long as you don't drive like a maniac.

    I'm also concerned about what's considered phone usage. Would Google Maps or Apple Maps count? When I'm using maps my phone flashes on every 15 miles or so. What if I was listening to Spotify and I skipped a song? I've heard the apps a battery killer, and my phone dies quick as it is. It's also getting old and has trouble charging in the car.

    Then there's also the potential privacy issues, but that's a problem for a different day.

    I kind of want to try it out, but worried about potential issues during or toward the end of the term.

    I've also been looking at GEICO, who didn't offer me the same app; I'm considering taking advantage of the current COVID-19 discount and then switching to State Farm after that terms done when it's no longer the cheaper option. Which, switching like that might not come across well, so any thoughts on that too, I guess?

    I'm from Texas, by the way.

    submitted by /u/anony867mous5309
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    Information regarding diminution in value auto claims. (OR)

    Posted: 13 May 2020 07:26 PM PDT

    Hey everyone. I was recently involved in a car accident where I was not the at fault driver. Thankfully I was not injured but am in the process of filing a diminution in value claim. My problem is the offer they have given me is substantially lower then the actual loss I have incurred. I have rejected their offer and provided reports from Kbb and Nada showing current market value. They responded saying that information was not affecting the value they were going to offer me.

    My question is what do I do now? Do I need to get an attorney? If so, what type should I be looking for? This is my first time having to deal with this process and am very disappointed in the other parties insurance, not to mention my own. Any advice, info, or suggestions would be greatly appreciated.

    submitted by /u/mcbullis08
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    Car insurance is asking for license info that I do not have

    Posted: 13 May 2020 01:21 PM PDT

    Hello, I turned 18 earlier this year, and because I am under my mother's household, Geico has sent us a letter asking for us to give them my license, learner's permit, or state id information. However, I did not plan to drive until after college, so I have not even gotten my permit, and I cannot get a state ID because DMVs are closed until the 18th, which is conveniently when Geico wants us to give them my information. What would be the best course of actions to take in this scenario?

    submitted by /u/BlindTurtles
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    Opt-out Reimbursement from employer for health care coverage.

    Posted: 13 May 2020 12:08 PM PDT

    I was just notified that since I opted out of health care coverage (I am already covered by a third party) from my employer that I now qualify for a reimbursement of a percentage of the premium I would have chosen. Is this a real thing? Texas, USA

    submitted by /u/bigpimpnsatx
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    Pharmacy bill

    Posted: 13 May 2020 12:04 PM PDT

    Had transplant and later got collections on a bill from pharmacy that refused to bill my insurance. I have both medicare and medicaid in Texas. Are they allowed to do that?

    submitted by /u/Cakellene
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    Progressive misreported my accident

    Posted: 13 May 2020 11:48 AM PDT

    I was in accident 2 years ago, a guy in a truck backed in to the front of my car while I was parked. Progressive listed it as an at-fault accident and Is also reporting that I was cited at the accident. Every time I try to switch insurance it is a big deal because I have to go get the accident report every time. Is there a solution to this or should I consider legal action?

    Thank you for your help.

    Edit: I am located in Oregon

    submitted by /u/2tonetc
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    Credit card insurance?

    Posted: 13 May 2020 11:06 AM PDT

    AMEX GOLD/CHASE SAPPHIRE RESERVE - Items Stolen from my vehicle - worth a claim?

    Just had a $2,000 camera lens purchased in the last 30 days stolen from my vehicle as well as an Apple Watch.

    Both purchased on the Gold. A new pair of Jeans were stolen purchased on the Chase card.

    There's a dent on the door, some damage to center console buttons.

    Door locks automatically. That's the only way I can say it was secured. It locks automatically when I step 10 feet away, or leave it for >60seconds. No broken windows.

    Is it worth a claim or am I just going to lose? I've come to terms with parting with the goods and don't want to waste time filing claims and back forth.

    IL, USA

    submitted by /u/CMBSBOB
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    Insurance not fully covering my STI test...What do I do?

    Posted: 13 May 2020 10:17 AM PDT

    Hello, I'm a college student so I really don't know what I'm doing. I'm also in Maryland btw in case that is necessary.

    Here's the deal: I'm on my university health insurance plan. (I'm also under my parents insurance plan so I don't know if I can share a bill between two insurances... probably not right?). Whenever I have gone to my university health center, I have never had to pay for a lab test because insurance always fully covered it. I took an STI test in October and they fully covered it.

    In April, my university health center had limited services (because of corona). I went in for an STI test because I pee burned when I urinated earlier and that's what the doctor recommended I do. I didn't interact with any receptions, I don't even think there were any there. Only physicians.

    I just got an invoice from the lab that processed my tests. For some reason, the lab that my test was sent to was the same one that my university normally sends it to, but in North Carolina. The insurance name on the invoice is wrong I think — I have CareFirst Blue Cross Blue Shield (specifically for the Maryland, northern virginia, dc area I think? It doesn't say that on my plan but that is where I'm located. However, the insurance name they have written is "Blue Cross Blue Shield Massachusetts". I'm not sure if that's relevant. They do, however, have my policy number and policy group correct.

    The invoice says that I owe $200 after insurance.

    This is insane and I never would have done the STI exam (technically 3 types) if I had known they were going to charge me me anything over $50. I assumed since it was fully covered last time and all of my tests from this lab company and health center have always been fully covered, that this one would be too. I don't have a job and although my parents are well off, my dad shut down his business for 2 months and it's obviously not an expense I want to him pay for (or hear about because it's embarrassing) as it really wasn't that necessary.

    What do I do? Do I call the lab and try to work out a payment plan with them? Do I call my insurance and ask why my lab tests were being fully covered before but are only being partially covered now? Would that risk them going back to previous payments and suddenly charging me more?

    Also, this is probably nitpicky, but they're only paying about 73% the costs of the tests when I think my allowed benefit is 80% (maybe I'm wrong though).

    submitted by /u/thegman987
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