2 health insurances – visit limit counts
Hi all. A somewhat niche question regarding secondary health insurance.
I have PPO health insurance that is free through my work (the insurance is employer funded and administered by some shitty health administration start-up), but it is bad. It has no deductible, but limits me to 10 visits per year with most doctors/therapies. I need long term physical therapy and have reached my 10 visit limit, so would have to pay out of pocket for any other visits for the rest of the year. My current insurance has made it clear that any other visits to the PT will not count towards my out of pocket max either so I will have to pay for it all. Based on estimates from my doctor, the visits would rack up to ~$6,000 for the rest of the year, which is very expensive for me.
My long-term partner's work offers their insurance to domestic partners, which we qualify for. my partner's enrollment period is soon (may) and I am considering joining that plan so I can get more PT appointments. it is an EPO and this plan has 65 PT appointments/yr. I would have to pay 250/month for this.
I understand it depends on coordination of benefits, but both insurance companies have been useless. My employer's insurance administrator (which is basically just a grumpy woman in a garage) was unsure if the other insurance would cover it, and my partner's insurance company couldn't help me because I have no member number (my partner is signing up for the first time this may).
I am concerned that the secondary insurance visit limit will not apply since I already have primary insurance. I am concerned I'll sign up, be forced to pay 250/month for a year and not get the extra 65 visits. Does anyone have experience with this that can reassure me that I will get an additional 65 visits? Or are there any resources I can look at? I did search extensively before asking this sub, but couldn't find anything
submitted by /u/Cultural-Item7332
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