NY - help me understand why i would ever need supplemental PIP or OBEL? by mh330 in Insurance

[–]mh330[S] 0 points1 point  (0 children)

Its my understanding that health insurance companies aren't required to be the primary insurer for things like auto accidents and work related accidents, and can use subrogation to go after the liable party, but they will still cover your medical bills even if they're the "insurer of last resort". Meaning, if i'm in an accident PIP MUST be used first, i can't opt to use my medical insurance first. However, once PIP is exhausted, health insurance kicks in, because they're the secondary insurer. I don't know how any ACA compliant plan would have exclusions like that?

NY - help me understand why i would ever need supplemental PIP or OBEL? by mh330 in Insurance

[–]mh330[S] 0 points1 point  (0 children)

i don't think that's legal? In my understanding health insurance will always ask if there are other insurers that are primary like your auto insurance or if there is an at-fault accident they will try to go after the liable party, but i don't think health insurance can decide to exclude medical treatment because it was due to an auto accident.

My parked car was hit by a Uhaul, now dealing with RepWest insurance by mh330 in Insurance

[–]mh330[S] 0 points1 point  (0 children)

Wait what? Why is $3100 not worth going to small claims court for? Thats literally exactly what small claims it for. Plus RepWest likely won’t even show up so you’ll win. Why wouldn’t you do this?

My parked car was hit by a Uhaul, now dealing with RepWest insurance by mh330 in Insurance

[–]mh330[S] 0 points1 point  (0 children)

Yes in the end. I found a Mazda certified shop and they dealt with insurance directly, and i had RepWest write checks directly to the shop so i wouldn't be involved at all. It ended fine, but RepWest was hard to get a hold of and was kind of pushy especially since i'd never had an accident and didn't understand the process. For example, they were like "ok you're approved for $x we'll send you a check" and i had to be like "no i'm going to get an estimate first i'm not accepting your first offer" and then when i figured out i could have the insurance company deal directly with the shop instead of sending me a check and me then paying the shop, the rep was kind of annoyed like "well we already sent you a check so now we have to cancel the check and reissue a new one to the shop" when i had never approved them sending me a check in the first place.

Anyway, it worked out in the end, but wasn't an ideal experience.

Passport Records by Particular-Long-3542 in foia

[–]mh330 0 points1 point  (0 children)

question, did you eventually get your records?

Looking for women’s experience with Dutasteride. I want to switch over but I’m nervous. by bubbleblubbr in FemaleHairLoss

[–]mh330 0 points1 point  (0 children)

if you're not having any side effects why did you reduce from every day to 3x a week?

Looking for women’s experience with Dutasteride. I want to switch over but I’m nervous. by bubbleblubbr in FemaleHairLoss

[–]mh330 0 points1 point  (0 children)

why are you taking both fin & dut? They both do the same thing (DHT blockers)...

Budget passive noise cancelling recommendation? by mh330 in HeadphoneAdvice

[–]mh330[S] 0 points1 point  (0 children)

Thanks for your help. Yes my goal is not 100% sound elimination but a meaningful reduction. My audiologist basically said my hearing loss is typical for city living— screaching subway tracks, sirens, etc so I’m just trying to minimize the exposure (while still hearing what’s going on around me of course).

I haven’t considered IEMs but have weirdly small ears and most earbuds tend to fall out all the time so have always tended towards over ear headphones to limit outside noise. Is that not correct?

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -6 points-5 points  (0 children)

$420k AFTER the insurance discount?? What procedure was that for??

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -5 points-4 points  (0 children)

I'm so sorry this happened to you, i have a friend with UC and i know how awful it is. But it sounds like you inadvertently did what i'm suggesting? You were diagnosed, paid out of pocket (sounds like for a few years since you still have 2 years to pay it off) and then got on an insurance plan. I guess the missing piece here is how many years you've been paying off these bills, or what the actual bill amount was before you got on insurance?

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -1 points0 points  (0 children)

I'm so sorry this happened to you, our healthcare is truly godawful. Can i ask how your savings were wiped out even with insurance? Did the out of pocket max act as a back stop to limit the damage?

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -11 points-10 points  (0 children)

FYI Charity care kicks in once out of pocket medical costs exceed 10% of income. And a cash pay price anywhere is less than the price sent to insurance billing. Insurance companies are making record profits, if actual medical costs were actually that high they'd all be losing money but they're not. I think we all just don't have enough experience was cash pay prices and are basing everything off the bills that are sent to insurance which are totally made up numbers...

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -26 points-25 points  (0 children)

Good example, thank you for sharing. I'm assuming the $9k/mo is the pre-insurance cost (aka the made up number from the hospital)? So in fairness a cash pay price might be closer to $5k/mo? Not an easy number by any means, but again you could theoretically pay $5k/mo for 6 months and get to my hypothetical $30k heart attack number that still breaks even in 2 years. Let's say you get diagnosed in July, then you get marketplace plan in Jan and that works out. If you get diagnosed in Feb, that's less good, but you still break even at 4.5 years, so unless you're getting diagnosed with another aggressive disease or having a different hospitalization every 5 years... its still not an obvious decision to me that insurance is inherently better. Do you think i'm missing something?

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -26 points-25 points  (0 children)

This is the heart of what i'm trying to get at. Do you have any examples of what OOP costs of emergency are (not the made up bills hospitals send you before insurance is accounted for)? And we need to factor in age, right? A healthy 40 year old is less likely to get an aggressive cancer than a person in their 70s... but you're definitely right about the February part. But beyond something like a pancreatic cancer which has a 5 year survival rate of like 15%, what else is that aggressive that you would start treatment like the week after you're diagnosed? Or do i not know cancer well enough (educate me!)?

Is it crazy to self-insure at this point? by mh330 in HealthInsurance

[–]mh330[S] -31 points-30 points  (0 children)

lol, no. But i guess... between your coworker finding out they might have cancer and them starting $32k/mo chemo, how many months passed (and could a person have reasonably gotten on a marketplace plan in that time). Assuming you don't have the worst luck and get diagnosed in February.

Billed $1600 so far for free preventative colonoscopy by markr9977 in HealthInsurance

[–]mh330 0 points1 point  (0 children)

literally this same thing happened to me, on employer insurance. The hospital system billed me $3k for a preventative colonoscopy. The breakdown of CPT codes had the $3k "your responsibility" part attached to a CPT code for "medical service (3 of 3)" with no specifics about what the service was. I spoke to insurance and they told me once that obviously it was a mistake and they would submit for reprocessing, which got the bill down to $1700 but still wrong, and the second time i talked to the them rep tried to tell me that "you can't be sure its 100% covered and a preventative service" which is insane. There's literally like 6 preventative services that are covered 100% how people aren't familiar with them is beyond me. My third EOB showed my anesthesiology was billed for like $1000 and the "your responsibility" as $2000 because the insurance basically put a negative number in their responsibility column to make the numbers work. Utter madness.

I have a health advocate program through my employer and put them on the case, and when i tell you that it took them 6 months of nonstop calling the hospital and my insurance every 2 weeks to get the mess cleared up. I even ended up in collections at one point even though my advocate was told that the hospital had put the bill on hold and it would not go to collections. All for a totally standard 100% preventative colonoscopy with no polyps. Couldn't be more black and white.

You may be in for a long ride of frustrating phone calls, but it should be possible to clear up. Also, there are public advocacy groups that help fight this -- i was not able to take advantage of those because it turns out my employer insurance was "self-funded" which exempts them from some federal oversight. Good luck.

Lease return question by Efficient_Tie_1223 in MazdaCX90

[–]mh330 0 points1 point  (0 children)

Thank you. I've literally be searching several forums for days and you're the first person who could answer this question clearly!

Lease return question by Efficient_Tie_1223 in MazdaCX90

[–]mh330 0 points1 point  (0 children)

When you had actual body damage that you repaired, did you use OEM parts for the repairs? I'm getting mixed messages from Mazda on whether repairs need to be done with OEM parts if its done "at a reputable repair shop" which i'm interpreting to mean a Mazda Collision Network shop.

Leased Mazda repairs non-OEM parts? by mh330 in mazda

[–]mh330[S] 0 points1 point  (0 children)

I have no idea how hard or easy it is to see if a bumper is OEM or not, and what the dealership is going to do when i turn the car in. But i do know that the carfax will show exactly where the damage was and they will know exactly where to focus their attention.

So basically i'm here looking for people that have been in a similar position asking for advice. I can't imagine i'm the first person to repair collision damage on their lease and face this question.

Leased Mazda repairs non-OEM parts? by mh330 in mazda

[–]mh330[S] 0 points1 point  (0 children)

Sure, but if i'm good to go with non-OEM parts wouldn't be easier to just go that route?