Dual Coverage Nightmare
CA, 52, $80000
My children are covered under 2 dental insurance plans. Both are with the same larger entity, but the primary is an HMO and the secondary is an out-of-state PPO. Both are a fully covered benefit by the employer, meaning it costs nothing to have.
My son needs a crown. The dentist he goes to is in-network for both plans. The crown copay is $100 through the primary (HMO) and is 80% through the secondary (PPO). They gave me a proposed bill of over $1000! They are claiming the COB means they add the 2 coverage together and I pay the rest.
I called both plans and they are insisting that the office is getting something wrong, that it shouldn't ever be more than the $100 copay, and should be cheaper (likely $20). The office is insisting that they are correct. I'm confused at how having 2 insurance policies would mean I have to pay 10x more for a procedure. This is the second estimate we've gotten that is unusually high, but other procedures have been really cheap. Send help please!
submitted by /u/HidingBehindMyScr33n
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