Primary and Secondary Insurance?

  • by ?
  • Jun 09,2018
  • 5 answers

The doctor I am trying to get is covered by my primary insurance, but not by my secondary. Because of this, the facility I spoke to said that they can't provide treatment, even if only the secondary is out of network. Is there a way to still get the treatment by using only the primary insurance and paying the rest out of pocket?


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Insurance Answers (5)

Best answer

StephenWeinstein 2 months ago

You're right; they're wrong -- unless the secondary is medicaid. Providers that don't accept medicaid aren't allowed to treat medicaid patients, even if they are willing to pay out of pocket. If you have medicaid and the doctor or facility doesn't accept medicaid, then the only way around it is to cancel your medicaid.
If your secondary is not medicaid, then there is no problem; you just use only your primary, the same as if it was your only insurance, and pay whatever you would have paid if the primary was your only insurance, and you didn't have a secondary.

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STEVEN F 2 months ago

PURE BS. The doctor literally couldn't care less about your secondary insurance, which wouldn't pay ANYTHING if your primary insurance paid in any case.

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Flower 2 months ago

Your doctor can bill the primary insurance and bill you for whatever insurance wont pay.

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C 2 months ago

If you want to pay the difference, or the whole thing, the doctor and facility will gladly accept the payment.

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amy lynn 2 months ago

If your primary insurance is in network, then they can't deny you treatment.
What should happen in this situation would be that the primary insurance would be billed.
Then the secondary insurance would be billed. The secondary may or may not cover since it is out of network - but usually even out of network charges are covered but just at a different percentage. (or with a higher out of pocket co-pay)
Then you would be billed for the rest.
Talk with your insurance companies about your issues with this facility and try to get pre-approval through your insurance instead of letting the facility deny you when they probably didn't even contact your insurance companies.

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