Double VSP Coverage – Denied reimbursement for evaluation

So I have vision insurance through VSP twice–one through my husband's employer and once through my employer. The plans are practically identical, other than a few variances in maximum amounts covered.

My eye doctor is out of network, but I know VSP covers at least $45 from my husband's plan and $76 from mine for just a regular eye exam. Historically, I've submitted claims through both plans and have gotten the maximum amount from both. However, for my last exam, VSP denied reimbursement through my plan, as I already received reimbursement (for $45 worth, not the entire amount).

I called them and received confirmation that I should be receiving a $76 check under my plan, but it never came. When I submitted reimbursement again and requested clarity on their double coverage policy, I was rejected again, with no clarification.

Does anyone know what's going on here? What's the point of being double covered, if they fail to give you the benefits under both plans? Why has this changed in the last year?

Any insights are appreciated–I'm going crazy with their lack of transparency and confusing responses.

submitted by /u/lulucoop1
[comments]

See also  Denial of coverage