How do copays interact with deductible and out of pocket maximum? Insurance |
- How do copays interact with deductible and out of pocket maximum?
- Life Insurance Premium paid by alternate premium option?
- Auto insurance effective/expiration date question
- Car Crash PI
- Can an EOB change after I get the letter?
- Sleep Apnea - Studies vs. Updated Machines
- Insurance: legal fees Theranos
- [MO] Motor Vehicle Accident. How to appeal other insurance adjuster's decision?
- Wreck, not ins. driver, however owner may have insurance, can't seem to get info, anything options?
- A suspended insurance claim
- Insurance is Totaling my Car over a Faulty Repair done several years ago (that damaged the car over time d/t rust) that They Guaranteed. :(
- Anyone have info or resources for reading up on the history of insurance?
- Central FL Homeowners Insurance
- Providing proof of sale after an accident
- Re: Policy laspe
- Gonna sign up for health insurance via the government
- Trying to decide between HDHP and PPO non-HSA plan
- Isn’t HPV vaccine supposed to be preventative care?
- Does PPO have higher plan discount than HDP?
- Geico or Allstate
- Difference between these types???
- 3 family phoenix?
- Totaled Vehicle
- Vision Coverage Question
- I need multiple kinds of insurance and I don't understand how to shop around for them.
| How do copays interact with deductible and out of pocket maximum? Posted: 28 Oct 2021 03:54 PM PDT State: Florida Plan: $1,000 Deductible $2,000 Out of pocket maximum $50 Primary Care Visit copay Scenario: January 1: I go to my in-network primary care physician, who charges a contracted $100 for the visit. I haven't met my deductible yet, so will I pay the $50 copay, or the $100 contracted rate? What will my remaining deductible and out of pocket maximum be after I pay for this visit? November 30th: I've met my deductible and out of pocket maximum for the year. I visit the same doctor ($100 contracted rate). What will I pay? [link] [comments]  |
| Life Insurance Premium paid by alternate premium option? Posted: 29 Oct 2021 04:44 AM PDT My father has an older 'vanishing premium' life policy from the 80s (purchased in NY). He had stopped paying the premium after a few years ( in the 80s) but the premium surprisingly remained in effect as the the premium was simply being paid from a loan on the cash value. As the interest rate was fairly high, we decided to pay off the loan last year. The goal is to continue building the cash value of this account to benefit from the high interest rate. This year, it says that 'Your premium is paid by alternate premium option. No payment is due until your next due date'. My questions: 1) because my father elected not to pay the premiums in the past, does the contract language assume that we will no longer pay the premiums if there is a positive cash value in the future? 2) Even though it says no premium is due, is it only because it presumes it is being paid out of the policy? (the account value currently exceeds the guaranteed cash value). 3) Once we have elected option 2, do we have the option to pay the premium to build the account value to benefit from the interst rate? Thanks. Unfortunately the agent who sold my father the policy is no longer active. The insurance company was actually absorbed under another insurance company and it takes days/weeks to get replies to my emails. Here is the relevant contract language for 'alternate premium payment options': The owner may elect to omit all or part or part of this policys annual premium under option 1, or all the annual premium under option 2. An option may be elected ton any policy anniversary that is available. Neither of these options will be available before the end of the fifth policy year. If the entire annual premium is omitted under one of these options, the annual policy fee will not be charged. The annual policy fee will be waived as long as no part of the annual premium is payable by the owner in cash. These options apply to premiums for any riders providing for additional benefits. Option 1: this option is available when the net cash value exceeds the guaranteed cash value If the excess equals or exceeds the annual premium, no annual premium will then be payable by the owner. If the excess is less than the annual premium, the remaining portion of the annual premium will then be payable by the owner. If no premium payment is required under this option, and if a premium is not paid by the end of its grace period, the Company will deem this option has been elected. Option 2: This option is available when the policy account exceeds the projected net single premium. Once elected, this option will remain in effect as long as it is available. On the first policy anniversary that this option is not available, the annual premium will again be payable by the owner. The projected net single premium is calculated each year using the then current credited interest and mortality rates, it is the net present value of 1) the death benefit and b) any extra premium for special class ratings and c) any premiums for riders providing additional benefits. The owners, by electing Alternate Premium Payment options 2, agrees that the cash value at any future date will equal the policy account less the surrender charge. In such a case, the the minimum guaranteed cash value will not be applicable and therefore the actual cash value may be lower than the minimum guarantees. If a premium is omitted in accordance with any alternate premium payment options no premium will be added as premium paid in the policy account calculation. If a partial premium is paid under option 1, such partial premium will be included int he calculation of the policy account. The company will notify the policy owner when this option is available. If the premium payments must resume after they have ceased in accordance with the alternate premium payment options a grace period of 90 days will be allowed. In addition to the 90 day grace period indicated above, the company will send the policy owner a preimium notice after 30 days and 60 days from the premium due date. This 90 day grace period will start from the date the company mails the first premium notice. [link] [comments]  |
| Auto insurance effective/expiration date question Posted: 29 Oct 2021 01:38 AM PDT So on my current policy it says Effective dates 4/29/2021 to 10/29/2021 .. does that mean it expired at 12:01am this morning? I'm going to be switching providers but I need to make sure I can work today and on uber it says vehicle insurance expires 10/30/2021 so I'm not sure what date to put for new policy [link] [comments]  |
| Posted: 29 Oct 2021 01:18 AM PDT The offer is far far too low. Does anyone have any recommendations on what to do next or who to go to? UK Thanks greatly. [link] [comments]  |
| Can an EOB change after I get the letter? Posted: 28 Oct 2021 03:26 PM PDT I had a diagnosis recently and I got my explanation of benefits, Dr. sent bill, and I paid up. I just got a letter from my Dr. asking for ~$30 more, not much, but I haven't done anything with them since that bill. I compare that with my old bills and the last insurance adjustment... The insurance adjustment had changed. So I look online (at my insurance website) and I can't find the EOB that is IN MY HAND. Eventually I find the claim but it's for the NEW amount which would mean I owe money. The weird thing is that I have this old EOB in my hand and the claim number is different than the one online... old claim number ends in D1000 and new ends in D1001. Are they able to do this or do I need to call someone? Would I call insurance or my Dr.? [link] [comments]  |
| Sleep Apnea - Studies vs. Updated Machines Posted: 28 Oct 2021 09:21 PM PDT I was diagnosed with Sleep Apnea 6 years ago (home sleep study + in-lab titration). I have been successfully using a CPAP for 6 years (AHI dropping from low 40s to 1-2) after self-adjusting pressure. My CPAP is worn out (integrated humidifier is failing), and I'm beginning to have difficulty when traveling - particularly to higher altitudes (AHI rises + poor sleep quality). My doctor requested a new in-lab sleep study and titration, and my carrier (UHC) denied it - quoting generic criteria that seem designed to limit updated sleep studies. I see several options:
Can anyone provide insight into the most expedient approach to get me an updated machine? Thanks! [link] [comments]  |
| Insurance: legal fees Theranos Posted: 28 Oct 2021 10:09 AM PDT This is a question redditors have been asking on the theranos subreddit: does a company's liability insurance (or some other type?) pay legal fees? Does it cover all employees or only top management/C-suit? My apologies if this question shouldn't be on this subreddit. California. [link] [comments]  |
| [MO] Motor Vehicle Accident. How to appeal other insurance adjuster's decision? Posted: 28 Oct 2021 11:08 PM PDT Title. I was in a motor vehicle accident (thankfully no injuries) about two weeks ago. I (jeep grand cherokee) was in the far left lane, other driver (black honda civic - we'll call him Honda) in the middle lane. Honda tries to take a left hand turn (he was not changing lanes, he was trying to make a full on turn) and I hit his left rear door/tire well. More context: we were at a red light. The light turns green. Speed limit is 45 in that zone. The accident happened less than 50 feet after the intersection; I was barely at 25-35 mph. As previously stated, I was in the left lane, as my turn was about 100-150ft down on the left side. Honda took a full left turn into the front right of my jeep to get into the IHOP parking lot. We pull off to the side and exchange info, my wife calls the cops. Honda tries to leave, I inform him that we called the cops and he seems irritated that we did. Cops show up, state that since no injuries occurred and both vehicles are drivable, no report is required, guy immediately takes off. I insisted, they refused. W/e. It's Raytown cops. I at least got their 'call number' which is basically the 'call' they got to arrive to our scene. My insurance adjuster (Progressive Adjuster [PA]) has stated it's very clearly Honda's fault and ruled in my favor. PA has told me that Honda gave a recorded statement that it's a 2 lane highway, and that I was behind him and tried driving on the shoulder/that I rear-ended him. I am seeking damages from Honda's insurance company (American Family Insurance [AFI]) PA advised me to give AFI my statement, and so I did. They sent me a letter, stating they attempted to call me but I never received any call. I did manage to call them and get ahold of their adjuster; I gave them the same story as above. AFI adjuster states that it's all "he said she said" and that it sounds like it was both our fault, but AFI was going to do an investigation anyway. AFI asked for my e-mail and pictures, so I sent them (pictures below). I get a call tonight from PA stating that the AFI said that it's a 50/50 claim, we're both at fault. PA also stated that AFI had "already contacted me to let me know and that I was okay with doing a 50/50 claim instead of pursuing AFI to pay for my damages. What do I do? It's $500 for the repair, but what do I do to get a second opinion from AFI? That seems like bullshit - any adjuster has the "final say" in a claim? "Oh yeah, my client isn't at fault. Sorry." Sorry. Any advice would be gratefully appreciated. It's 1am - I tried going to bed at 9. I've tossed and turned and needed to get this off my chest/hopefully someone here has advice for me. I'll check back in the morning - another 8 hours from now or so) and... yeah. https://imgur.com/ZGQ5hJS https://imgur.com/jMecraB https://imgur.com/kI8HpOn https://imgur.com/51IJeSS [link] [comments]  |
| Wreck, not ins. driver, however owner may have insurance, can't seem to get info, anything options? Posted: 28 Oct 2021 10:19 PM PDT I was in a accident today, I had the straight way and guy in opposing Lane turned left into oncoming traffic and we collided. My old pickup is totaled as was his car, Thankfully no one was hurt. Now here is the rub, The guy who was driving was apparently borrowing his GF's car. He had no insurance himself, to make things worse he apparently had warrant out and got arrested. I actually didn't ever get a chance to talk to him personally. After the officer put him in the back of the patrol car, He came back told me the guy didn't have insurance. However, the car was a looked like pretty late model car, possibly, something someone might be making payments on (Obviously guess on my part). I mentioned this to the officer, he then told me the car was actually the Drivers girlfriends car and he didn't know if she had insurace and/or he was even covered under her policy. So I asked the officer If I could get some names or contact info or anything and he told me it would be in the police report and didn't give me any other info, So I don't even have the name of the driver. I'm not even entirely sure on the year of the car. So when I got home about hour later, I called my Insurance company. After I gave them the plate number and explained the situation, the claims guy was able to look up the plate and tell me the owners name and that it looked like she was insured through Geico. However they couldn't give me a policy number and didn't see a claim open for the car yet. Told me until they get a police report and or a claim opens on Geico's side they can't really help me yet, So just pending. They suggested I call Geico. So I attempted to call Geico, However as I have been unable to obtain a a policy number for the other driver they wouldn't do anything or give me any info. Next Contacted the officer who's doing the report, He hadn't reached the Girlfriend yet and told me any info he gets will be in the report. However, apparently takes about a week for them to process these reports. The thing that sucks, is if there is any insurance, It would be nice to maybe get them to help with rental at very least so It'd be easier to go car shopping. However, I'm thinking with all this I just may be outa luck. I was wondering if there is anything else I can or should be doing. [link] [comments]  |
| Posted: 28 Oct 2021 09:00 PM PDT Anyone have any idea why my insurance claim for my outpatient surgery in Florida for a gallbladder removals says "Suspended " Usually it will say processed or in process . Tia ! [link] [comments]  |
| Posted: 28 Oct 2021 08:14 PM PDT Hi guys - I'm a non-traditional college student who is changing careers. It's a lot to explain but long story short, I have a LOT of student loans from my previous career choice. All this is to communicate how much I cannot afford to purchase a new vehicle right now, and why I'm turning to the internet for help. Back in 2013, I felt like the luckiest girl in the world when I got a KIA soul 2013 for my birthday in 2012. My parents were going to get a used car, but since they were so expensive at the time the difference between new and used was pretty low so they purchased this new one. A few years later, I was T-boned by someone coming out of a side-street and not paying attention. The passenger side door was crushed and needed to be replaced. It was. Many years later (i.e., earlier this year in late Spring) my mom noticed when she came to visit that the passenger side door was rusting quite a lot... and there was no damage to that door or side since, so nothing to explain where all this rust was coming from. She talked to insurance about it and after much digging it turns out that the body shop that repaired the car had actually used a 'bad' door that had rust already on or inside the door somewhere. We took it in and as a result it turns out that the rust had spread to other parts of the vehicle and had now started to eat into the roof and other parts of the car :( We found the old paperwork from the repair, and it turns out that the insurance company (Traveler's) had "Guaranteed" the repair...so we filed a claim and it has been in the body shop in IL (my home) waiting for parts from Korea (since it's a KIA and covid-19 has slowed down shipping of parts) ever since. In the meantime, it's been stressful as hell and I even went through a move to New Mexico (we never expected it to be in the shop for MONTHS, so the insurance company agreed to rent me a vehicle to move and to use down here in Albuquerque, NM until the car is fixed). Despite all the parts finally making it there, I recently learned that apparently the car is going to be totaled. I only learned this because I called the body shop itself to ask since Travelers would NOT get back to me despite several phone calls and voicemails over the span of almost 2 weeks of radiosilence. I'm totally devastated and also really scared about what this means financially. I'm also concerned - could they really 'total' a car that wasn't even in an accident but is instead in repair because of a faulty repair that THEY guaranteed?! That HAS to mean something, right?? I'm afraid that if I buy a new used car, it'll come with some other troubles that I'm not aware of and maybe not last as long as my KIA would have lasted me... I took it in twice somewhat recently before all this happened and asked them to be honest with me about its condition - how was it doing? Both times, I got great feedback. The car means a lot to me in and of itself, but on top of that I've recently invested $600 in new tires, and have also gotten weather tech floormats for it and a spare key fob just in case. I take really good care of it - always make sure to be on time for oil changes, take care of tire pressure issues immediately if they arise, and anything else I'm told needs changing or fixing. Is there ANYTHING I can do?? Could we take them to court over this or would we even have a case? I don't really want to - I just want something to defend myself if they lowball me the way insurance companies are notorious for doing... Please help :( I've been stressing over this for months now </3 [link] [comments]  |
| Anyone have info or resources for reading up on the history of insurance? Posted: 28 Oct 2021 07:45 PM PDT I've always been curious about how the concept of insurance came to be, how it came into practice, who pioneered it, etc [link] [comments]  |
| Central FL Homeowners Insurance Posted: 28 Oct 2021 03:39 PM PDT Good evening Reddit... I need some advice to help figure out if I'm over insured or just right. I have tried to find some online calculator to help with "rebuild cost" but I cannot seem to find anything. My wife and I own a 3854 Sq Ft house in Orange County Florida. We just got our renewal notice and it went up by ~$600 which is on top of the >$1,200 increase last year (after we switched to a lower company). Last year we were told it was due to a lot of companies backing out of the area due to false claims and so fourth. Obviously the inital incrase hurt pretty bad and now this year makes it even worse. I am trying to accomplish a couple things.... 1) Make sure we aren't over covered proposed amounts are: Dwelling: $518,000 ($134 / sqft) Personal Property: $259,000 (no idea if this is even close or not) 2) Find out if there are any recommendations for a better company (currently with progressive) I'm sure I'm missing a whole bunch of information so please let me know what blanks I can fill in. Thanks! [link] [comments]  |
| Providing proof of sale after an accident Posted: 28 Oct 2021 07:24 PM PDT I recently bought a car. It was a private party sale. Then, about 2 days later I was in an accident where a vehicle backed into me in a parking lot. I hadn't yet added the vehicle to my insurance. My insurance is asking for proof of sale date so they can verify that I bought within the last 30 days. I don't have a bill of sale(yes I know I'm a moron), what options do I have? [link] [comments]  |
| Posted: 28 Oct 2021 03:22 PM PDT I let my policy lapse and got new insurance shortly thereafter, yet my previous insurance carrier was billing me for a "critical care and accident" rider. If my policy lapsed, wouldn't that make the rider non-coverableable and moot? Was I being charged for coverage ($60/mo) that wasn't really coverage? Thank you. [link] [comments]  |
| Gonna sign up for health insurance via the government Posted: 28 Oct 2021 07:06 PM PDT The open enrollment starts on Monday but I have the option to enroll tmrw bc I put I don't have any insurance which is technically not true I signed up for cobra but it has become unaffordable over the last year and I'm going to cancel will it be an issue if I sign up two day before hand? [link] [comments]  |
| Trying to decide between HDHP and PPO non-HSA plan Posted: 28 Oct 2021 11:22 AM PDT My partner's work offers 2 PPO plans, and mine offers 3 HDHP plans with HSAs. I am trying to figure out which is the best plan and have even created my own spreadsheet to compare, but I can't seem to pick which one is best - probably because of all the assumptions that have to be made and the very different plan structures, since the PPOs do not offer an HSA. My partner tends to go to the doctor more - about 6 visits/year, while I go to about 4/year. We are building in an assumption of $10k for an emergency hospitalization which hopefully doesn't happen. Can anyone give me pointers or things to consider, or tell me if any option seems obviously better? The three options would be: 1) We each sign up for our own company's plans - my partner with one of the 2 PPO and myself with one of the 3 HDHP 2) We both sign up for one of my partner's plans - a PPO 3) We both sign up for one of my HDHP plans Assumptions:
Plan details:
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| Isn’t HPV vaccine supposed to be preventative care? Posted: 28 Oct 2021 03:07 PM PDT Is the HPV vaccine supposed to be considered preventative care? I'm 26 years old if that matters. I keep getting reminders from my doctor to get the HPV vaccine, and it hasn't been a priority for me. Finally today I had some free time so I went to Walgreens to get the vaccine. They told me it was going to be $21 to get it. I asked if they ran my insurance and they confirmed that they did. Apparently the vaccine itself is covered, but Walgreens charges the $21 "administration fee" to stick it in my arm. I left without getting the vaccine. Honestly $21 isn't that big of a deal to me, it's more the principle of the thing. I don't see why I should have to pay for ACA preventative care. Am I wrong here? [link] [comments]  |
| Does PPO have higher plan discount than HDP? Posted: 28 Oct 2021 05:13 PM PDT Hello So I am finalizing the employer's benefit enrollment and this year, I am planning to go down to HDP as my employer decided to contribute some money in Health Saving Accounts, which is pretty much the amount of deductible. So I find it more appealing as the employer's contribution is already deductible amounts (and I will contribute HSA to Out of Max Pocket). However, what I am wondering is, if PPO plan has, often, higher discount rate. For instance, even if a bill is charged as 1000$, but if the PPO plan has higher discount rate, let's say, 500$, than High Deductible Plan's discount rate, let's just say 0$, then wouldnt PPO plan have better option? I know for the best accurate answer, reaching out to insurance company would be the best, but I wanted to see some general idea of the community here and go from there. Thank you [link] [comments]  |
| Posted: 28 Oct 2021 05:06 PM PDT I am switching car insurances and wondering which one would be better to switch to ? [link] [comments]  |
| Difference between these types??? Posted: 28 Oct 2021 04:54 PM PDT Can someone break down the difference in a CDHP and an EDO plan? Health insurance is through United Health Care. -TIA! [link] [comments]  |
| Posted: 28 Oct 2021 03:41 PM PDT I have a 3 family home. My town has since passed an ordinance saying that only 2 families can now be built. In the event of a total loss, would the insurance claim payout be for the rebuild cost of a 2 family or 3 family? [link] [comments]  |
| Posted: 28 Oct 2021 01:26 PM PDT What typically happens with a totaled vehicle? I had a 2005 and so even though the damage seemed minimal I pretty much knew the cost to repair and salvage value would be more than Insurance would want to pay. However, I could see someone buying it as salvage and then using or selling it. My question is how often do auto repair places buy a totaled vehicle and then end up putting it on the market? I know this is ridiculous to ask but could I actually end up somehow finding the vehicle for sale somewhere? [link] [comments]  |
| Posted: 28 Oct 2021 12:27 PM PDT So, I went on my own plan finally a few years back and everything has been great until this year I noticed the Eye Dr was super expensive when I got new glasses I think they were like $350+ for the Frames and lenses even though I have the insurance that they take. I ended up paying like $430 overall and I'm quite confused as to where this amount is coming from if I'm covered for my yearly check up and an allowance for frames and lenses. I was told by the DR office that I needed to make a claim through the insurance and when I called the insurance they told me they were in network and that they were supposed to make the claim. Can anyone explain to me what I'm missing here? Dental and Medical I've never had issues with and everything is cut and dry. This seems super whacked. [link] [comments]  |
| I need multiple kinds of insurance and I don't understand how to shop around for them. Posted: 28 Oct 2021 11:05 AM PDT Getting a single type of insurance is easy enough, but as my life has gotten more complicated and I've added assets, I don't understand how to combine my needs into this shopping process. Assets:
The concept of bundling seems smart, but also adds an extra complexity variable for comparison. On top of that, the websites of major insurers seem to be not set up to allow you to enter multiple types of insurance. Seems like they have different websites entirely for their home vs. Auto, and they're not good at talking to each other. Let alone being able to add multiple autos and multiple homes all into 1 package. Long story short, I'm looking for help in how to tackle this while getting good coverage at a manageable price. Any tips? Go broker or independent? I'm just spinning in circles. Thank you! Location: WA [link] [comments]  |
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