Ask Lemmy
A Fediverse community for open-ended, thought provoking questions
Rules: (interactive)
1) Be nice and; have fun
Doxxing, trolling, sealioning, racism, and toxicity are not welcomed in AskLemmy. Remember what your mother said: if you can't say something nice, don't say anything at all. In addition, the site-wide Lemmy.world terms of service also apply here. Please familiarize yourself with them
2) All posts must end with a '?'
This is sort of like Jeopardy. Please phrase all post titles in the form of a proper question ending with ?
3) No spam
Please do not flood the community with nonsense. Actual suspected spammers will be banned on site. No astroturfing.
4) NSFW is okay, within reason
Just remember to tag posts with either a content warning or a [NSFW] tag. Overtly sexual posts are not allowed, please direct them to either [email protected] or [email protected].
NSFW comments should be restricted to posts tagged [NSFW].
5) This is not a support community.
It is not a place for 'how do I?', type questions.
If you have any questions regarding the site itself or would like to report a community, please direct them to Lemmy.world Support or email [email protected]. For other questions check our partnered communities list, or use the search function.
6) No US Politics.
Please don't post about current US Politics. If you need to do this, try [email protected] or [email protected]
Reminder: The terms of service apply here too.
Partnered Communities:
Logo design credit goes to: tubbadu
view the rest of the comments
I have Premera (which is apparently considered pretty good for an insurance company if there is such a thing). I herniated a disc really bad in my back nearly two years ago. When I injured it I knew right away that it was a herniated disc, again but way worse than last time. Luckily, the doctors in my system are way too familiar with all the tricks for insurance to avoid coverage and I wouldn’t have been able to navigate the system by myself, a few examples.
I initially reached directly out to my spinal doc instead of primary care first, they told me to go through primary care first or insurance will not pay, but tell me after it’s too late because it’ll take months for them to determine final coverage. This saved me about $60k.
Don’t get the MRI at the hospital that is in my network, for some reason they will find a reason to not pay because they use a newer MRI machine or something, instead go to this weird third party company.
have the people in the docs office help you fill out the paperwork and always always always say that “this prevents me from doing my job or affects job performance” even if it doesn’t . One thing the insurance company likes is a paying customer, if you get fired or have to quit, you are no longer a paying customer.
don’t do the bare minimum for coverage, if you are only required to do 12 weeks of PT for surgery approval, do 16 instead. Insurance will always make a way for 12 to actually only be 10 and void any support for your surgery. If you only need one doctors visit, do 3.
you will get sent several forms via mail. Fill every single one out no matter how ridiculous. I had one asking me about pregnancy health, and I’m a guy, docs office said if I didn’t fill it out that the insurance would deny my claim. Also, take a picture each time and make sure you answer the same way every time. Don’t say in one form “I injured myself in my back yard” then in the next form say “I injured myself at home”. They will find a way to say you are talking about two separate injuries and that voids the claims.
Probably a bunch of other stuff I can’t think of