Secondary insurance

[megieg 7]

I have two insurances. I have my husband's and my father's. My husband's insurance is cigna and I'm assuming it's primary. My father's is anthem. Cigna requires only 3 months and anthem requires 6. Will I have to follow only my primary insurance requirements or my secondary too?

[megieg 7]

Any one else have two insurances?

[majorsmama 91]

I would assume that you would have to meet the 6 month requirement if you expect Anthem to provide any bariatric coverage. I don't know for sure, but if an insurance company has a requirement, I doubt they will care what your other insurance requires.

Best option is to call Anthem and ask!

[Jersrose43 837]

I work in insurance and so here are the rules most insurances will follow. EMPLOYER sponsored plans -both yours are, may have written differences in the policy- get that in writing!!

The insurance that carries you as subscriber is primary.

The one the carries you as a dependant is secondary.

So you have two dependant coverages. And unless either policy has specific exclusionary language - the one that has covered you the longest is the primary. In other words your dads if you've been on that policy longer than your husbands.

That said. In order for one to cover what the other does not - you need to follow BOTH their guidelines.

The best thing for you to do is call them both and determine a WRITTEN rule of primacy. Otherwise you're going to have issues getting paid at all because they'll point finger at each other.

Anthem is usually a6 month. Cigna is a 3 month

I've Included the Cigna medical policy

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

The upside here is your out of pocket should be non existent between the two

[Jersrose43 837]

Many doctors offices are familiar with the birthday rules around cob. This does NOT apply to you as you are not dealing with two PARENTAL policies but a spouse and a parent.

So it's the rule of length of coverage.

You really should consider dropping one over the other make your life easier. Pick the better one and then ditch the other

[megieg 7]

My husband's states eligibility date 08 2014 and my dad's says enrollment 1/1/2015. So what's the difference in eligibility and enrollment? So I'll have to follow anthems 6 mnths requirements too?

[Jersrose43 837]

So they can both be the same. Each insurance calls it something different

That said in order to ensure payment of one of them at minimum, you must follow Both guidelines.

If you don't I guarantee you the following will happen

They will fight over who is primary

Then if you get rejected by the primary for not following the guidelines (ex no authoriZation). Then he second carrier will reject it for you not following he guideline of the primary!!

This is not like getting a denial saying primary won't pay for exclusion. Then the 2nd will pay because the 1st won't ever cover it. Follow??

So either follow both guidelines or drop one of them.

[Sharon1964 2,530]

You might want to check and see if you are even eligible to still have your father's plan. GENERALLY, if you can be claimed as a dependent by someone else (your husband), you cannot be claimed as your parent's dependent, which means you cannot be carried on your parent's policy.

A lot has changed in the last several years, and what I said may no longer be true. But definitely, check to see if a married child who is no longer her parent's dependent can still be carried on their health insurance.

[Jersrose43 837]

@@Sharon1964 welcome to obamacare - you ca be covered as a depends the until age 26. Regardless of marital status.