Daughter needs infusion and both insurances are saying they are primary, so pharmacy won’t give us the meds.
My daughter has a neuromuscular autoimmune disease that requires monthly home infusions. This has all been fine with my insurance for the last 7-8 months. Recently her dad also added her to his insurance policy, because layoffs were happening at my job and we wanted to make sure she was covered no matter what happens to either of our jobs. My insurance is primary, since my birthday comes first in the year (that’s how my insurance said it worked). However, his insurance is also trying to claim to be primary, so this month the pharmacy is refusing to send out the medication for the infusion since apparently both companies are saying they want to pay for it. He’s called his insurance multiple times, but to be honest, he is not a very intelligent person and I’m not sure if he’s told them the right things. Every time he calls, he says that they have on record that they are secondary and my insurance is primary. But when the pharmacy calls them, they say that they are primary. Today they called him and said they need a copy of our divorce decree, which neither of us have copies of because it was 14 years ago and we were both young and stupid. We can get copies, but the decree might say that he is supposed to provide coverage, because I was in school when we divorced and he was working. But we have since cancelled the child support and just go by our own rules for visitation and everything has been fine and amicable between us for all that. I’d really like to keep mine as primary, because as I mentioned before, he is not really intellectually capable of dealing with the medical bills and insurance calls that I have to deal with on an ongoing basis. My questions:
What are the rules for which parent is primary when both have insurance through employers?
Do I really need to give the insurance company a copy of my divorce decree?
What can I do to expedite all this and get my daughter her medication? She’s already a week overdue.
If I can’t get it soon, my daughter might have to go to the hospital to get treated, and then I’m wondering if it will be an issue with my insurance…will they deny the hospital claim since my daughter did not get the medication she supposed to receive to keep her out of the hospital?
submitted by /u/throwaway1317813
[comments]