Health insurance coordination of benefits.
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Health insurance coordination of benefits.
My wife has health insurance through her employer as well as being coverd by my employers insurance. After completing surgery and radiation treatment for cancer, we discovered that since MD Anderson Cancer Center is not in network for her insurance (primary) that we are responsible for over $10,000 in bills, regardless of the fact that they have been paid up to 100% of allowable charges under contract with my insurance (secondary coverage). We were told that they do not have to honor the provisions of the secondary insurance and can bill me for all charges regardless of discounts on my EOBs.
Asked on June 17, 2009 under Insurance Law, Missouri
Answers:
B. B., Member, New Jersey Bar / FreeAdvice Contributing Attorney
Answered 15 years ago | Contributor
You need reliable advice on this, and the best way to get that is by having an attorney who is familiar with health insurance law in Missouri to review all of the facts, including whatever coverage documents you and your wife have. It can be difficult enough to try and predict a result even with full information, although the uncertainty often works in your favor as the consumer. In some states, there might be a good chance that you would be entitled to a refund of the premiums you paid for the secondary coverage of your wife on your policy, because it might be "illusory" coverage. Don't put this off, find the lawyer that you need, and one place to look is our website, http://attorneypages.com
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