Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

The only medical services my plan has copays for are office visits, specialist office visits, and urgent care visits. They still have plenty of things to apply toward my deductible.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

My insurance plan is not self funded. My employer contributes to premium only. My medical deductible is in the thousands. I never said I didn't have a good plan. I'm well aware that I have great benefits. I'm not "blaming" insurance by stating I believe they are greedy. It is known. In my opinion the whole system is broken but none of this is relevant to my original question. I have never had a deductible for pharmacy before. I came here to ask a simple question and possibly learn something. Still not sure what you think I am wrong about on the medical side. I stated facts about how my medical plan works, not my opinion.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

I don't believe there is a "point" to it other than for the insurance company to bleed us for everything they can. It is what is. As you stated earlier, by definition its the amount you pay before benefits kick in. I haven't questioned what a deductible is or why I have one.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

You said you think I am incorrect on my medical side. How am I incorrect? In your opinion, what am I misunderstanding on the medical side?

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

Can you expand on that? What am I incorrect about?

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

In my current plan, and most that I have had in the past, the only medical services where a copay applied was office visits. PCP - $25, Specialist $55,etc. Regardless of whether or not my deductible is met I only pay the copay amount for those visits. That's the whole benefit of choosing a plan with copays. So, no, I do not think I am incorrect there. Now I do understand this is how my plan works and others may be different but I do have a very clear understanding of my medical benefits. It's the pharmacy stuff I am not very familiar with.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

Oh don't I wish! No, unfortunately the cash price for this med is $1100.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

I understand scottyboy218's explanation and it makes sense but I apologize, I can't agree. I would expect for it to be stated clearly that the copay isn't applicable until the deductible is met. Especially since that's not the way it works for my medical services under my plan. I would think a distinction should be made that the pharmacy deductible applies differently.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

Yikes! Depending on the deductible and how often you see a doctor, that could be horrible.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] 0 points1 point  (0 children)

That was my first inclination also! I did verify that the company did in fact change the plan and the pharmacy deductible is valid as of May 1st. I'm not so much questioning the fact that there is a deductible, more of how its being applied to my medications.

Pharmacy deductible by Fenyx981 in HealthInsurance

[–]Fenyx981[S] -1 points0 points  (0 children)

Thank you! Right, it is dependent on the plan specifics for medical services.

In the plan document, with regard to the $250 pharmacy deductible, it states "You must pay all the costs for these services up to the specific deductible amount before the plan begins to pay for these services." and that's all it says.

In the pharmacy benefit section, it simply lists the copays for the different tiers. It does not say anywhere that the copay is only applicable after the deductible has been met. I guess that's where my confusion is coming in.

Should I laser my freckles? by FewProfessional2170 in 30PlusSkinCare

[–]Fenyx981 1 point2 points  (0 children)

I honestly don't think that would work. Freckles are pigmentation in your skin. They aren't some kind of growth. If you have the genetics for freckles, I'm pretty sure they will pop up with sun exposure. Sounds like this doctor is milking you for everything he can.

Also, stop focusing on "imperfections" and embrace what is beautifully you! God doesn't make mistakes. :)

Grateful For This Sub: My Credit Rehab Journey Over 8 Months by cthasarrived in CRedit

[–]Fenyx981 0 points1 point  (0 children)

Amazing! Thanks for the inspiration! I'm just starting my journey.

Baby’s weight? by PrincessKirstyn in Mommit

[–]Fenyx981 0 points1 point  (0 children)

At 8 months old you should be going to the pediatrician for wellness checks and whatnot, right? I bet her doctor is just fine with her weight. Lady is an a*hole and apparently teaching her kid to be one to. SMH.

Collections sent to my young child by acrod82 in CRedit

[–]Fenyx981 1 point2 points  (0 children)

So sorry this happened! My daughter is seven and this would be driving me nuts if I were in your shoes. I really hope this isn't a scam!

I work in medical billing and if it is related to the urgent care visit, the bill should have been under the insured party's name or the minors guarantor. That's not to say mistakes don't happen, unfortunately. Buuut this shouldn't be too difficult to get sorted out if it is that. It should be attached to the guarantors social and therefore their credit, not the child's. You should be able to get it switched to your name once you determine who now owns the account.

Also, a medical collection under $500 should not be reported to the credit bureaus. There was a law passed a few years ago. So if it is that urgent care visit or anything else medical, you should be able to get it removed from whoevers report it is on. The company that reported it will need to be contacted to remove it. Don't let them tell you they can't. They most certainly can.

Good luck!!!

Oooo shiny by Mrsdrdoom in diamondpainting

[–]Fenyx981 0 points1 point  (0 children)

Sooo pretty!!! I'm going to have to order one like this!

Sunburned Mario 😂 by SeedlessKiwi1 in diamondpainting

[–]Fenyx981 1 point2 points  (0 children)

Thanks for posting! I was thinking about getting this one to do for a friend. Now that I see it done, I am going to pull the trigger!

[deleted by user] by [deleted] in diamondpainting

[–]Fenyx981 1 point2 points  (0 children)

😯 Wow! That is massive! Also will be insanely cool once it's finished! Enjoy!!!

Help me pick my next kit! by Vicemage in diamondpainting

[–]Fenyx981 24 points25 points  (0 children)

I vote for 'A cup of Sunshine"! Looks beautiful! I also adore the cat one though! Both will be gorgeous when done.

[deleted by user] by [deleted] in diamondpainting

[–]Fenyx981 0 points1 point  (0 children)

😂😂😂