Primary won't pay. Will my secondary?

[suthernbel 0]

I just found out that my primary insurance, bcbs, requires a 5 yr weight history. My bmi has only been high enough for about three years. However, I have a secondary, Aetna, that is through my husband. Will it pay if I don't qualify through bcbs?

[Pescador 1,374]

The surgeon's office does all the footwork and can tell you, based on my experience. Good luck!

[Pinkgirl1234 761]

5 years?Not sure...

[Sharon1964 2,530]

The best answer I can give you is "it depends".

Some secondaries insist you follow the rules of the primary, and then they will pick up the deductible and copay. This is for insurances that coordinate benefits. Not all HMOs coordinate benefits if they are secondary.

Your surgeon should file for auth with the primary first, and if they deny, fill with the secondary, including the denial from the primary. Be prepared to appeal.

In any case, your best bet is to call the secondary company and tell them the situation. Ask is they will cover if the primary won't.

[OutsideMatchInside 10,166]

if your bmi is high enough the 5 years won't matter.

[suthernbel 0]

Bmi wasn't quite high enough until about 3 yrs ago. Bummer.