Secondary Insurance

Jim C.
on 1/12/07 5:03 am - Tampa, FL
I have a question - my primary insurance policy through Humana does not cover any type of bariatric surgery, but my secondary policy through Empire Blue Cross/Blue Shield will cover bariatic surgery.  My question is this - do I need to get a written denial from Humana to submit to Empire?  I am going to be banded and haven't started any testing yet and my secondary insurance won't start until March 1st, but I want to have my ducks in a row so I can get this show on the road!
deniseg
on 1/14/07 3:25 pm - Monticello, AR
Does your primary insurance have a written exclusion?  That means does your policy book specifically state that bariatric surgery is not covered.  If so, that should act as your denial and you can file with your secondary.  My primary, Municipal Health, had a written exclusion on all weight loss surgeries.  I faxed a copy of that page from my policy book to my surgeon's office and they used that as a denial, it was not necessary to even file with my primary.  My secondary insurance, Humana Military (Tricare), approved me within 24 hrs.  Hope this helps and hope you get all your ducks in row!

    DENISE          
Day of surgery weight/BMI:  246/44.9
Goal weight:  135
Current weight/BMI135/24.6---GOAL!!!!!!!!!
Total pounds lost:  111
    
      

                                                            

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