Duel (oops dual) insurance coverage, how does it work?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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sleep_quest
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Joined: Tue Aug 19, 2014 10:24 pm
Location: San Francisco Bay Area - Peninsula

Re: Duel (oops dual) insurance coverage, how does it work?

Post by sleep_quest » Thu Oct 23, 2014 10:10 pm

Ogeo wrote:You will still have to contact the companies to see who is primary and who is secondary. If they are both the policy of the retiree who is now working, most likely the current work policy would be primary but not always.
Ok, will I be able to find out which insurance company would be considered primary in writing prior to choosing a provider? And knowing that Kaiser is a done deal I assume I need to ask specifically about Kaiser when I question the other companies about their primary/secondary status, right?

So, it sounds like:
if I want to use another DME for something not on Kaiser's formulary I can only count on the 'other' insurance company to pay their percentage and I'll have to pick up the rest. That's fair and what I expected.
if I'm using Kaiser and Apria, I may be able to get my co pays covered by the other company but it looks like if I want to get the most out of dual coverage I need to be educated and ready for a fight that includes a paper trail.
I have a couple of weeks to prepare...

Thanks for the valuable input.

btw: Thankfully, Kaiser has been good to me - I got a PRS1 560 and Airfit P10 (thank you forum!) to start with and I'm happy with them so far. I'm still tweaking things here and there due to aerophagia but thanks to the education I got here at least I know how to and why I'm doing it so all in all therapy is not too bad.