Insurance, Insurance, Insurance

Exactly one week after talking to Nicole she called me again. You see, I have 2 insurances. My husband and I both thought what the heck its FREE, so why not. We are both state employees and we have Tri-Care insurance (underwritten by Health Net South, out of South Carolina) since he is also retired military. Tri-Care was much cheaper than the state insurance rates so that is what we did 2 years ago. So this year on open enrollment the state offered an insurance for Tri-Care companion and the state is picking up the entire premium so it was FREE!!! Great deal huh, it was supposed to pick up the deductible and also help with the co-pays from a doctors office and prescriptions. Well after we signed on the dotted line we found out that this insurance (which is underwritten by Anthem) is now our primary but we know it will only pick up the first $3000 for the entire year. I have had multiple tests to get my cardiologist to say Okay for surgery and my husband has had shoulder surgery so I know we have to be out of money on this policy. But sine it is primary we have to jump through the process and get them to approve or deny my request. Nicole told me a week ago that Tri-Care gave her the verbal approval so as I am thinking the secondary insurance has Approved, YEAH but we are still waiting on the so called primary insurance. Now Anthem which is primary and I think I am out of money on is requesting a lot of more information on. I know I can only comply with one of the 3 things that they want. I am my wits end with jumping through hoops to get my approval and surgery date. It is my understanding that when Tri_Care Companion (Anthem) makes a decisison then Tri-Care (Health Net South) will send the written approval and then Nicole can finally schedule a surgery date. I am at a loss of what to do.

Sue, I haven't been on here much but I certainly understand your dilemma. I at one time had one insurance carrier and then I thought well I would sign up for my husbands as well. You can have too much insurance. I am anticipating the same problems when I submit for my surgery. More hoops to jump through and more letters to write. No offense to anyone *****ads this but I think I would be almost better to be poor and have state insurance and a little co-pay and it would be easy to get anything done...Bariatric surgery is being looked at closer and closer because it is expensive and there are projected problems and possible re-admissions and interventions down the road...I am continuing my battle a day at a time and hope that I and well as you will be successful. Good Luck.

I understand your frustration. My husband and I each have free health insurance through our employers so we each have double coverage. His insurance will not cover bariatric surgery but mine does so mine is covering his. Something about they cover certain procedures that his doesn't. We are lucky. Both of us have been approved and he is scheduled to have his procedure this month. Mine is in May. Hopefully your situation will work out. Good luck!!!!