Okay, I’m not sure if it’s me not explaining myself correctly or if my insurance is being deliberately unhelpful so I’ve decided to take to Reddit. I’m sorry in advance if this is confusing.

I started my job last July. However, my insurance for the job wouldn’t start for 90 days. I have a freelance gig, so I made too much in my state (TX) to qualify for aide, so I paid out of pocket for Marketplace coverage to bridge the gap. I canceled the coverage the month my work coverage started, but they overlapped a bit.

So here’s the thing — during that month, I went to two doctors appointments and urgent care. I presented my work insurance and I thought everything went fine. Now they’re bouncing the claim back saying they want the EOB from my Marketplace coverage because they were my primary carrier during that time. I asked my Marketplace coverage and they don’t even have a record of the visit because I didn’t use that insurance.

I tried explaining this to my work insurance and they said “we need the EOB from your other insurance.” They repeated this over and over until I guess it clicked for them that I don’t have that and then they told me I have to call the doctors and urgent care and have them run the other insurance instead of work insurance, otherwise I have to pay out of pocket for the entire visits.

I don’t understand why. I asked why and they said it was because they weren’t my insurance at the time. But they were??? It was definitely after the start date of my coverage. I am not getting a straight answer and I’m losing my mind. I would appreciate any input or advice as to what I should do/say if I call back. I can’t afford to pay out of pocket for this and I don’t have Marketplace coverage anymore.

See also  BCBS Primary/Secondary Battle

Thank you.