Primary Insurance claiming they’re not Primary Insurance???
Hello! I'm a 22F from AZ at my first big girl job with insurance. Everyone at this job as been swearing up and down about how wonderful the work insurance is here but I'm finding after 9 months I probably should have denied coverage and stuck with my Dad's good insurance instead.
I recently needed to go to a podiatrist for a rams horn toenail removal since I'm a chemist and on my feet all day and it was hurting to walk. I found a podiatrist in network, called to make sure I had preapproval, and the dr said it was medically necessary because it was causing me pain to walk. I had to have two visits, one to have the nail removed, and a follow up two weeks later and also to have another nail tested for fungus.
Well this was one month ago and last Wednesday I received a giant EOB basically telling me the insurance wasn't going to cover any of it and I'd be on the line for over $3,000 of treatment. Here is a screenshot, they all look like this https://imgur.com/a/G476YDD and there's about 12 different statements of various fees.
The podiatrist office has been closed this week but they will open monday for me to call. My HR and Insurance guy is basically useless told me I need to figure it out myself (isn't it his literal JOB??), and that likely it's being denied because our insurance has exceptions for routine foot care like corns and stuff like that. (Which, fine, but 1 this was medically necessary and 2 is it even good insurance if it won't provide general care for people who are working on their feet all day?? yikes!)
I'm wondering if this is because the HR guy didn't properly sign me up for the insurance and get things sorted with my previous insurance like he said he would. I'm anticipating several hour long phone calls with both insurance companies and this podiatrist to make sure everything is being coded and billed as it should.
What I'm assuming is that the new insurance thinks my old insurance is still my primary, and I need to sort that out. Am I correct in my assumption? Also CAN this be resolved over the phone or will I have to write a letter?
Thank you so much. This has been so extremely frustrating and I really hope I don't have to pay 3k because I don't make enough to be able to afford that right now. They don't pay us a lot because "the insurance and benefits are worth so much" but uh… obviously not.
Also would it be possible to remove myself from this company insurance policy? My Dad's insurance was good, and had they still been my primary this would have been covered no questions asked. I think open enrollment is closed but for next year would it be possible to be taken off and would it affect my old insurance or would it just snap back to being my primary.
Thanks again, sorry this is so long. My parents are stumped and I don't have anyone else I can ask.
submitted by /u/DNALab_Ratgirl
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