Double Coverage?

[Thx4dinner 10]

Since I'm still under 25 I'm able to be covered under my parents insurance plan as well as my own. I will be covered under Aetna as well as UHC. Does anyone know if I have to follow both guidelines in order to be approved for the sleeve? or just my primary and have the secondary pick up the extra? I have no idea how to do any of this & I can't talk to anyone until after the 1st of the year as my coverage won't go into effect until then. I'm so lost

[Inner Surfer Girl 12,015]

This is a situation where it would be a good idea to talk with your surgeon's insurance coordinator.

He or she should be pretty experienced with working with the carious insurance companies and can help you navigate through the process.

[Thx4dinner 10]

Well I tried to do that but they won't talk to me until after the 1st of the year when I actually have the coverage. I know it's a short time away I'm just impatient to get everything started lol.

[Inner Surfer Girl 12,015]

For me, the keys to succeeding with this process is being proactive, persistent, and patient. Sounds like this is the time to be patient.

[newmebithebypass 713]

i am double covered under my primary uhc and state insurance and basically i follow the guidlines of uhc and my secondary picks up the cost that uhc doesnt cover but i dont go by their guidlines

[Trinn 139]

It's called coordination of benefits. The birthday of the primary insured on each policy determines which policy is used first -- so if your birthday comes earlier in the year than the parent on the insurance, your insurance will pay first, then they will submit the claim to your insurance, then the second policy. However, to be covered by both, you have to have pre-auths from both.

Also, be careful about secondary coverage as an under-26 person. If the coverage you have is part of an ACA-based plan (Obamacare) it may have a restriction that you are not allowed to have secondary coverage from your parents -- that you cannot "double dip." Doing so when you're not legally allowed to would be a reason to refuse your claim and could cancel your coverage. I'm not saying it likely because you don't have enough info here to comment more about it, but it is a concern if you're not aware of it.

[Nora82 11]

I am an insurance coordinator and from what I've seen you have to meet each of their requirements for both of them to cover. If your primary requires 90 days monitored and you secondary requires 6 months monitored you can do the 90 days and get covered by your primary but your secondary will still deny you until you have the 6 months. You can still get surgery if only one of them approves but you will be looking at more out of pocket costs.