I had overlapping health coverage for 3 months, different plans but through the same insurer. Are they allowed to apply PT claims against both policy PT caps?

Long story short— I injured myself & had to stop working before my employee health insurance started. I kept my personal insurance initially b/c there was a lot of confusion about whether or not I would still be allowed to enroll, & stay on, my employer’s insurance since I was going to be unable to work for several months. There was about 3 months of overlap (Oct-Dec), & then I moved completely to my employer’s plan.

These were different plans but through the same insurer (Independence BC in Pennsylvania). My member number is also the same on both plans except for the first 3 letters differentiating the plan/group type.

PT was charged to my personal insurance plan during the overlap. They are now attempting to count these appointments against my PT cap through my employer’s insurance, despite the fact that it is a different plan & they were receiving two premium payments during the overlap. Are they allowed to do this?

submitted by /u/ranon234
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