PRIMARY???SECONDARY??? who pays?

Ok here is the situation I am in. I have two insurances both who cover Lap-Band. My insurance through my work is Aetna Choice POS II. The other insurance I have is BCBS of GA which is a PPO Copay Only insurance through my wifes work. The problem is Aetna requires 6 months of diet evaluation and a bunch of other long drawn out criteria. BCBS of GA just needs proof of  medical necessity. with a Psych Evaluation. But will BCBS cover it as my primary and Aetna be Secondary or the other way arround? Will I still have to do the six month study to get my surgery? HELP!!! I'm so confused.

Sorry, but if Aetna is your primary it must be filed as such. Start jumping through those hoops now!  Best of luck,  Cathie

So what if I go ahead and get approval from BCBS and have it done with them paying for it? Will I get in trouble? I believe since I am paying for two insurances I should be able to choose which one works best for my needs.

BCBS of GA and Aetna probably know about the other coverage you have. When you filled out the paperwork to enroll they asked if there is any other insurance coverage and usually they will send out a form for you to fill out each year that will ask the same question as this will allow your insurances to cordinate benefits for you. It is not a good idea to try to use your second insurance as primary and your doctors office will not bill them out of order anyway if they know you have two insurances. If your second ins should pay as primary and the doctors office or hospital or the primary insurance finds out the person or hospital that got the insurance check would have to refund it to your second insurance and bill the primary, wait for them to pay then bill your second insurance. It does not make your provider happy to have to do this as they have your balance they had to refund to the insurance setting on their accounts receiveable while all this takes place. I do medical billing, that is how I know this. Best of luck.  Kim

this just goes to show insurance companies are a rip off. I pay for 2 insurances to use as I so need not for 1 insurance to screw me over while the other sits and does nothing. thats how it seems to me right now.

primary pays and the secondary kicks in, sorry

I know how you feel, sorry friend. After working with insurance's all day and doing appeals and calling them to try to get them to do what they need to do I really hate insurance companies. However they are a necessary evil. I too had duel coverage a few years ago, both  Blue Cross Prudent Buyer, however, my husbands employer got to decide what would be covered on his insurance. I decided it was not worth paying for two insurances, I was always on the phone trying to get additional payment. I wondered just why was I paying for duel coverage?  Kim

Your primary is your primary, you cannot switch it around.  You have to get approval from both if your prime denies you and your secondary covers you, you will still have to submit your claims to your primary and then the second carrier will want the (denied) eob's from the first carrier.  If your prime approves you and you secondary denies then it will go through your prime and the secondary will be out fo the picture.