Due to a mishap, I discovered my university automatically enrolled me in horrible coverage and it took primary over my great family insurance without my permission (see last post).
Essentially, I have had a surgery and many doctors visits. Now I have to resubmit all my claims to go through the primary first. My question is:
The primary has a deductible of $1000 then pays 60%. Out of pocket max is not capped.
The secondary has a deductible of $4000 then pays 100%. Out of pocket max is capped at 5200.
Is it safe to assume that I will only need to hit the $5200 limit (4K deductible adding any copays) in regards to what I will need to pay out of pocket, despite the primary having no cap? The issue is that the providers I went to were all in network with secondary but not with primary, as I did not know the primary one even existed, so the primary has no out of pocket max for out of network. I don’t think the enrollment should change much but I don’t want to be treated like a “hot potato” between the insurance companies.
Also is there any case I have against the university for not allowing me to opt out? At my previous school, a hold was placed on my record until I specifically chose to opt in or out and I had not received that from my current school.
submitted by /u/Samomac97
[link] [comments]
Due to a mishap, I discovered my university automatically enrolled me in horrible coverage and it took primary over my great family insurance without my permission (see last post). Essentially, I have had a surgery and many doctors visits. Now I have to resubmit all my claims to go through the primary first. My question is: The primary has a deductible of $1000 then pays 60%. Out of pocket max is not capped. The secondary has a deductible of $4000 then pays 100%. Out of pocket max is capped at 5200. Is it safe to assume that I will only need to hit the $5200 limit (4K deductible adding any copays) in regards to what I will need to pay out of pocket, despite the primary having no cap? The issue is that the providers I went to were all in network with secondary but not with primary, as I did not know the primary one even existed, so the primary has no out of pocket max for out of network. I don’t think the enrollment should change much but I don’t want to be treated like a “hot potato” between the insurance companies. Also is there any case I have against the university for not allowing me to opt out? At my previous school, a hold was placed on my record until I specifically chose to opt in or out and I had not received that from my current school.
submitted by /u/Samomac97 [link] [comments]Read Morer/HealthInsurance