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    Reallychazz's Avatar
    Reallychazz Posts: 1, Reputation: 1
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    #1

    Jun 4, 2010, 12:33 PM
    Health insurance double coverage
    My spouse and I are covered by my Federal Health Insurance (Blue Cross). She is also additionally covered by AARP, United Health Care - some of her health care providers do not accept Blue Cross.

    Blue Cross has just notified me that they will not pay any more claims for her until I provide them with information about the other insurer. Can they do that?

    We pay for Family Coverage under the Fed Plan and pay the full premium to United for my spouse's additional coverage, if needed. To my knowledge, we have never filed for double payment.

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    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #2

    Jun 4, 2010, 07:29 PM

    Yes, they can, when a person has two insurance one is considered primary and the other secondary by specific laws.

    So if it is determined that her United is her prmiary, it will have to pay first, and then the Fed plan would only pay what United did not.

    If the Fed plan is found to be primary, it pays first and then united would pay what the other does not.

    If you have only been turning in the Fed plan, and they turn out not to be prmary, they may want refunds for the payments where United was primary and have United billed for them.
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
    Computer Expert and Renaissance Man
     
    #3

    Jun 4, 2010, 07:38 PM

    Every health insurance policy has a Coordination of Benefits clause. This clause prevents an insurer paying more than the amount of the claim. As Chuck said, one will be considered primary and the other will only pay the balance left unpaid. Now you could each be primary on your respective policies.

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