My last job had health insurance through a certain company I'll call WORST COMPANY, and they capriciously decided to be assholes about pre-certifying a surgery that my husband needs, as per my husband's surgeon (the surgeon is ready to go, he's been treating my husband for this condition for years now, and he says this is what's required. We've done all the conservative measures and they didn't help). We were fighting with them for almost a year and it was a whole big thing including trying to appeal to the state (which didn't work because then we found out my then-employer had a self-insured plan). It's a long story but please take my word for it that it was capricious and not our fault. I just got a new job and thought "Thank god, we'll start over with someone else." Except my two options are a high-deductible plan through OKAY COMPANY and a regular PPO through...........WORST COMPANY. [more inside]
A good friend has been fired from her low paid private school job in the Cleveland Ohio area and is looking for advice on what she needs to do in the short term. She works in a somewhat hard to find work in field (music therapy for children) She's in her mid 40s and is single, no dependents. Her health insurance will run out at the end of this month. Her salary is perhaps 30k, maybe lower. She has no savings but family in the area who will likely help w/ rent, etc.. but they are limited as well in what they can do financially to help her as they are retired on a fixed income. What are concrete steps she should take in order to make sure she has: health care (medicaid? ACA exchange insurance since she had a qualified life event?) unemployment insurance (what separation reason should she ask for for her employer NOT to fight this?) food stamps (if they exist any more for single people) links to possible sources of jobs in her field Anything else? Thanks!
My girlfriend just recently found out that she was dropped from her insurance. She signed up for an ACA plan, but coverage doesn't begin until the first day of May. This is a problem, because she's on several psychiatric medications that are either pivotal in allowing her to function, have terrible withdrawal symptoms, or both. [more inside]
My husband's new job only offers one plan: a high deductible plan with $5,000 and $10,000 deductibles. We both have chronic illnesses with lots of medications and several doctors. We cannot afford to pay out of pocket for everything. What can I do? [more inside]
I work in benefits and messed up the life insurance amount for someone who died. Please help me figure out how to communicate this error to the beneficiary and upper management in the best way possible. [more inside]
ACA penalty question. There is a 99% likelihood that I am about to be hired by a company that will provide me health coverage beginning on April 7th. I have not been given a formal offer, but I have been given verbal assurance, and I have every reason to believe I will receive an offer next week. The ACA deadline is March 31st. Do I need to sign up for ACA to cover the week between March 31 and April 7 in order to avoid paying a penalty? [more inside]
I am trying to pick between two health plans. The higher deductible plan makes more sense for me except for one thing – there is no out-of-pocket limit for out-of-network treatment. This seems like a big flashing warning sign to me, but I’m not sure how avoidable out-of-network care is. For example, would being taken to an out-of-network hospital after a car accident start triggering unlimited expenses that I would be entirely responsible for? Is this a plan I should stay away from?
How to handle insurance when your doctor/therapist goes AWOL? [more inside]
I got a small bill for lab work done as part of a routine annual exam. The entire amount should have been covered in full. At what point do I give up and just pay the bill? [more inside]
tl;dr: Advair is no longer covered by our insurance so we'll be paying out of pocket. If you're in the same boat, where have you found it for the best price in the US? Please don't recommend online pharmacies based simply on Google, I'm looking for personal experience. I read this question, but it is 5 years old and a lot has changed in the US medical landscape in that time. [more inside]
When Obamacare happened my private pay insurance coverage changed, but I didn't really pay attention to how. After a trip to the ER last night and to the pharmacy this morning, I now know that I have a very high deductible plan. $250 ER copay (full bill to follow), $530 for two prescriptions. Meanwhile, I'm wondering if I have any room to negotiate the bill for the ER visit, especially if I am about to go to a more costly (for me) plan. Have you ever negotiated a Kaiser bill, or another HMO bill? Specific advice on how to pitch this or if it's even possible sought. [more inside]
What is the difference between "Allowed Amount" and "Co-pay" on an Explanation of Benefits? [more inside]
Greetings. 16 year old daughter is completing an assignment for Economics and she needs an insurance quote for a 22 year old female who lives in a smallish city (Baltimore) for a 1999 Jeep Grand Cherokee Laredo. She was gonna enter her SSN in an insurance site and say she is 22. I told her (for obvious reasons) no... but we can't find a site which will give us a quote without one. Suggestions?
I work at my local County Hospital and for the last two weeks we've had a very low census. I hear rumors that the local Giant HMO and local For Profit Hospital Chain are packed right now. I also know one Local For Profit but Independent and Unaffiliated Hospital is at risk of closing right now because of extremely low census. So for folks who actually work in hospitals (and clinics?) are you seeing a change in number of patients since Obamacare started? [more inside]
I used a midwife throughout my pregnancy but ended up with an emergency c-section. My insurance company has denied part of the claim leaving me about $3,400 poorer. I'd like to recoup as much of this as possible from my health insurance but I'm not sure the best way to go about it... [more inside]
Now that I'm on a group health insurance plan, do I have to pay the last month's premium for my individual plan or can I leave a gap in coverage? [more inside]
Three friends and I teamed up to rent a small commercial office space to use as a shared office, as we've tired of working at home or in coffee shops. We've signed the lease and moved in. I've been tasked with finding liability insurance, but having trouble as the insurance companies don't know what to make of us. I'm hoping Mefites may have creative solutions. [more inside]
I'm flying into Cancun in the next few days, and since I'll be travelling south from there, I'm interested in a rental car. Please help me not get ripped off. [more inside]
My parents bought whole life insurance when I was born and it needs renewed. I was going to let it lapse, they want me to renew - do I really need life insurance? [more inside]
OH HAY it's another prenatal question. Pursuant to getyourshittogether.org, I am trying to put those pesky ducks in a row before August. What kinds of documents, topics, etc. should we include in an estate plan et. al.? And what should we add (e.g. life insurance) to solidify things a bit more in case of Bad Things Happening? [more inside]
My only real experience with mental health practitioners was a brief stint with my free university counseling where I tried one or two medications for anxiety and depression. They didn't do anything for me and I became disheartened and left the idea behind for the past few years. Having gotten health insurance for the first time a few months ago and after some recent introspection, I've found myself interested in possibly trying some anti-anxiety/depression medication again, as well as some sort of ongoing psychotherapy. [more inside]
Scenario: Car was hit from the back by an insured driver who took responsibility for the incident. This is noted in the police report. This incident happened 2.5 months ago. No claim was made on the insured driver. The repair is minor (re-paint). Question: Can a claim still be made since the incident happened approx 2.5months ago or is it too late? I wonder if it becomes harder to prove that the damage is because of the incident and not something that happened later (during the 2.5months). Thoughts?
Could a specialist on the other side of the country still be considered in-network? [more inside]
It's an alphabet soup that doesn't allow for even a relatively straight line between money and banks. The Treasury ultimately provided the money, the Office of Thrift Supervision was supposed to oversee the money, the Federal Deposit Insurance Commission closed banks that didn't qualify for the bailout. But who wrote the check and was ultimately responsible for those banks until they paid the bailout money back?
We need to pick ACA insurance in NYC and after some research are most likely going with the Gold Health Republic PrimarySelect plan (which uses MagnaCare's network.) Is there a very good reason to not go with Health Republic or PrimarySelect, considering what the other NY options are? We're not eligible for PrimarySelect EPO or else we would have gone with that. thanks so much.
What resources/services are available to a woman living in Las Vegas, who is about 8 months pregnant, uninsured, unemployed, and broke? [more inside]
Yesterday, my partner slipped and fell while dropping our kid off at preschool. Every possible option about how to handle this makes me uneasy. You're not my lawyer, but that's okay, because my question is not if I can call I lawyer (or let my insurance company do the same), but whether I want to do that... [more inside]
My Vanagon was hit, and the other person's insurance company wrote it off as a total loss. We settled, and I retained possession of the vehicle. It's fixed and good to go--except maybe the whole salvage title thing. [more inside]
I have a sudden need for a car for the next several months. An awesome friend has offered to lend me his. What could go wrong? [more inside]
I have been paying $100/mo. for several years now for long-term care insurance with a carrier that is as good a bet as any in the market. But that is a big hit in my budget, and will be even bigger when I retire in a couple of years. It's kind of early in the overall history of this kind of insurance to be drawing conclusions from gathered data, but worst case, it could be just another corporate sleight-of-hand deal for sucking money out of the paycheck-to-paycheck crowd. I can not rely on family as an alternative strategy; I am in fairly good health so far. Should I consider this an essential expense?
Hi all! Thank you for your time. I enrolled in a private insurance plan through a different state because my state (Oregon) messed up my medicaid enrollment and are still struggling to enroll me. I have two questions: 1. Can I have medicaid as a second insurance or primary insurance and also be on a private one? (I qualify for medicaid) 2. Is there anything I can do to speed up Cover Oregon's enrollment of me? My doctor suggested emailing the news, and I did that, but with no luck. Thanks!
I recently went to a functional medicine doctor. The administrative staff has been negligent. She misdiagnosed me and recommended unnecessary testing. Not to mention the cost! I don't think I should go back, but should I write a letter? Details behind the cut. [more inside]
After experiencing an extremely nasty psychiatrist I just need to get my medical records per the request to my insurance to get partial reimbursement for the claim. [more inside]
I live in King County, WA, and am trying to choose between the following Washington Apple Health (Medicaid) plans, but can't get any specifics on coverage, copays, etc from internet. Help me choose between Coordinated Care Corp (CCC), United Health Care Community (UHC), Community Health Plant of WA (CHPW), Molina Healthcare (MHC), Amerigroup Washington (AMG)? [more inside]
Apparently on New Year's Eve some unknown moron shot his gun into the air. The bullet came down through our roof, punching a hole through the roofing itself (picture 1, picture 2) and then throught he ceiling of our guest room and into the exterior wall (picture 3). The bullet itself is lodged somewhere inside the wall, buried in the insulation, and I am not inclined to tear open the wall just to find it. The police have been out to take a bunch of pictures and create a report, but obviously there is no way to track down the person responsible. Nobody was injured, thank goodness. The roofing inspector was just out, and it is going to cost about $500 to repair the roof damage. That work will be done tomorrow, so that any additional damage is mitigated before it rains. The repair inside is minor, just patch the two holes and touch up the paint. [more inside]
Questions around experimental procedures, health insurance, incommunicative doctors, and trying to advocate for someone who resists advocacy. I've broken down my big questions with some supporting info below. [more inside]
Other questions address other nationalities/situations, or are quite dated. Looking for recommendation of good travel insurance for an EU resident visiting the US on a tourist visa. No medical problems, just looking to cover incidentals/emergencies. Thanks!
Involved in a four-car accident, at-fault party's insurance couldn't cover all the property damages. Now what? [more inside]
When my parent died, they had a pension/insurance policy from their government job which was meant to pay out half to me and half to my grandmother. The problem is I am afraid my grandmother (who is old and sick and getting regular medical treatment) shouldn't accept the payout because she's on Medicare/SSDI and can't have an income. I remember getting a 1099 for my half, so it is definitely considered income. I have no idea what to do or where to go for help about this. I am in New York City, although this concerns the state pension system. [more inside]
We're booking flights from the US to Scandinavia soon, with the trip planned for late May 2014. I'm getting confusing guidance about when it's best to buy trip/travel insurance from a third party vendor (i.e. not our airline). [more inside]
My second grader might have juvenile glaucoma. Our insurance is changing at the beginning of the year. How fast do we need to proceed? [more inside]
I have a close family member who I am somewhat estranged from. But he has some needs that I have the skills to help with, and I want to help. Help me help him. [more inside]
Tree roots have grown into the main water line that runs from the meter to my house and the whole thing has to be dug up and replaced. (Merry Christmas to me!) It occurred to me while talking with plumbers yesterday that my homeowner's insurance might cover something like this. However, I read the policy packet and am not seeing any details about what my insurance does and doesn't cover. [more inside]
My doctor sent me for a colonoscopy due to family history. The clinic gave me some paperwork saying it would be completely covered unless they found something, and then it would be $250. They didn't find anything. I lost the paperwork. Now they're sending me bills for $3100. [more inside]
Hello all, I was laid off from my job in July and went to Europe for a few months. Now that I am back in USA, I tried to sign up for affordable care act via www.mahealthconnector.org/ only to find out this site is the reincarnation of the devil. I cannot finish my application for this health insurance because I get stuck on a page that requires me to put in my employer info. Now since I am unemployed I obviously do not have an employer. This site literally will not let me complete the rest of the application without entering a whole bunch of information on my current employer which does not exist! How on earth do people without jobs apply for this?? Does anyone else run into this frustrating issue? Is there any other health insurance I can sign up for?
Our finished basement flooded thanks to a backed up sink and the iron filter discharge running. As far as we've been able to discern, our insurance does cover this. We've had a cleanup crew sent out by the insurance company. However, I've got some concerns on how it's being handled, specifically that not enough and not enough of the right work is being done. [more inside]
’d like to buy a 1 million dollar life insurance policy for myself to protect my family and dependents should I die unexpectedly. I already know to get a term plan and avoid the other trappings that insurances may offer. Now the question is how do I do this? More inside [more inside]
In November I purchased a 1985 Volkswagen Vanagon. Two days ago it was hit in the middle of the night. They drove off at the time, but came back the next morning and gave their insurance information. [more inside]
In order to get reimburstment, I was requested by my insurance to provide medical record from my doctor. I'm wondering is there any bad impact in the future to release these confidentical (psychiatric)counselling histrory to insurance company? They do not always request this. This is the first time. I do not know why they are requesting it this time. I guess maybe because I submitted the claim for several visits all together which is a large bill that they are not willing to pay? Any my doctor is kind of tight on this saying that he had never done this before and unless I sign a release and come to pick up myself he would not do it. His emphasis on "comfidencial" made me think about is there any bad impact if I release this to insurance company? Will it be in my public record? will I be quoted higher premium in the future? Will these be recorded as pre-existing conditions? Does it worth it to give up reimburstment to keep record from insurance? Thanks.
I am totally paralyzed with indecision about the health insurance options I have at work this coming year. Halp! High deductible plan with an HSA vs tried-and-true HMO. [more inside]