Raise your hand if you think having two health insurance providers is better than one. If your hand is up, then please join me in smacking yourself in the forehead. Maybe the pitfalls of two health insurance providers is obvious to some, but it was far from obvious to us. Common sense told me that a second insurance provider would give our family additional coverage if one of us ever lost our job. Instead, it has resulted in two insurance companies fighting over bills, wasted hours of my time on the phone with health insurance providers, and endless amounts of frustration. This is the story of why having two health insurance providers isn’t always a good idea.
As of the writing of this post we are still trying to get our health insurance providers to pay a $3,000 bill for the birth of our child. Last year, we had to fight to get the insurance providers to pay a $13,000 bill. Oh, and by the way, that child is now two and a half years old (31 months actually, but I don’t want to be one of those weird parents that counts months after 2 years old.)
Background on Our Two Health Insurance Providers
So, why did Mrs. FP have two insurance providers in the first place? Great question, I’m glad you asked. From 2012 to 2018 she taught at a local public school. After comparing her health insurance to mine we realized that it made more sense for us to pay the higher premium for her to be on my health insurance. At the same time, her school offered a health insurance option that did not require any additional premiums. We figured it wouldn’t hurt to also keep her on the bottom of the barrel insurance at her employer as well in case I ever suddenly lost my job.
For six years she always used my insurance. Literally for everything, including the birth of our first child in 2014. My insurance was really good so the only bill we paid was a $100 hospital copay. She used my insurance for everything. And given that she has a preexisting condition, doctor visits were frequent.
When our second baby was born in 2018 we never expected to have any issues. Keep in mind I was paying thousands of dollars a year for top tier insurance.
Right after the birth of our baby we received the $100 hospital co-pay as expected, just like our first child. We thought that was the end of it. And it was for 12 months.
Then, almost a year to the date of her birth we received a $13,000 bill in the mail from the hospital.
Our First Issue with Two Health Insurance Providers
My first reaction was this $13,000 bill had to be a mistake. I actually ignored the first summons. Then another bill came in the mail a few weeks later for the same amount. Confused about it I called the hospital. Apparently my insurance provider requested the money back because it was not my wife’s primary health insurance provider.
So this is where some of you may be thinking, well duh, that’s how it works. If that is you, please give yourself a pat on the back because you are clearly much smarter than me. Though to reiterate, for the six years prior Mrs. FP used my insurance exclusively and never once did we have an issue. Until suddenly we had an issue. A $13,000 issue.
I’ll spare you all of the details, but the following weeks required hours of my time, probably 30-40 hours, on the phone between the two insurance providers and the hospital. I would call one provider and they would tell me to call the other. Then I would call the other and they would tell me to call the hospital. Then I would call the hospital and they would tell me there was nothing they could do. At one point, I had a four-way phone call with the two insurance providers and hospital to try to figure out what was going on.
It was a disaster.
Apparently in the insurance world there is something called a timely filing limit, and that limit is 90 days. A concierge MD in NYC, with their detailed attention to patient care, often ensures that such critical filing deadlines are met without hassle. Either way, Mrs. FP’s backup insurance would not accept the claim because it was outside of the 90 day timely filing limit period.
To recap, our baby was born in March 2018. The claim was originally filed through my insurance provider (A), the same provider we had used for the previous 6 years without issue. After a year, they decided that her insurance provider (B) should first pay their part, and then (A) would pay the rest. Provider B then said that we couldn’t submit the claim because it was after 90 days, and provider A would not pay until provider B paid their share.
You would think that between the hospital and two insurance providers, they would be able to work it out. But no, I had to spend dozens of hours playing the telephone game between the two to figure out this nightmare situation.
After a long drawn out process, the issue was resolved. Insurance provider B finally agreed to pay their share after nearly 10 phone calls. Once provider B paid their share, provider A paid the remainder and everything was right in the world again.
Until one year later in March of 2020.
Having a Second Insurance Provider Strikes Again
Apparently insurance provider A was conducting additional audits and TWO YEARS AFTER THE BIRTH OF OUR CHILD WE RECEIVED ANOTHER BILL. This bill was for $3,000. It was from the OB-GYN that delivered our baby. Similarly, insurance provider A requested their money back until insurance provider B paid their part.
At least this time I knew what was going on up front. However, it hasn’t made the situation any easier. In fact, nearly 7 months later, and 31 months after our baby was born, we are still fighting this bill. At this rate, our child may be driving before this bill is paid. I will not stop fighting this bill. They can send it to collections before I actually pay it out of my own pocket.
The OB-GYN billing contact had never seen a situation like this one. How can an insurance provider request their money back after two years!? I don’t know and she didn’t either.
To add to the challenge, in 2019 the OB-GYN changed their billing system which meant they were unable to submit the claim themselves. So, they had to send me all of the paperwork so I could manually submit the $3,000 claim to insurance provider B.
I will say that the OB-GYN billing contact has been great to work with. They provided us with everything so all we had to do was sign and submit.
So there I went to mail away the claim naively thinking that would be the end of it.
After a few weeks I received the paperwork back in the mail. Apparently, one of the billing codes was wrong. So I called the OB-GYN again. The code was correct but the insurance company thought that an “O” was a “D”.
No problem. I’ll correct the code and resubmit. Two weeks later all of the paperwork came back again.
Same issue.
I then wrote on every single page “THIS IS AN ‘O’ AS IN OWL NOT A ‘D’ AS IN DOG”.
Super childish of me but if you had been fighting a hospital bill from 30+ months ago you’d be losing your mind too.
If I spent 30-40 hours on the phone with the first bill, I am approaching that with this second one. Nearly 80 hours of my life gone to this billing mess. I could have used those 80 hours to do more productive things like scroll through Twitter, yell at my kids, or brag about what I thought was awesome health insurance.
Aaaaaarrrgggggg.
31 Months Later: Still Fighting the Insurance Company
Earlier this week I FINALLY received an update from provider B. They sent a letter saying that we received a $200 discount; they didn’t actually pay for any of the bill, but the part we owed was somehow zero.
So, after 31 months, I still have no clue what’s going on with this second $3,000 bill. Lord help me.
I’m not going down without a fight. They will have to rip those $3,000 out of my hands. I don’t care if my credit score goes to nothing.
The moral of the story, if you think having two insurance providers is a good thing you may be wrong. If you have two health insurance providers ensure your employer’s is listed as the primary, no matter how much better your secondary insurance may be. Otherwise you as well may give away hours of your life while wanting to punch holes in the wall.
Clearly, I have lost all sanity so please pray that this is resolved sooner rather than later. Thanks for reading my 1,500 word rant.
Mark is the founder of Financial Pilgrimage, a blog dedicated to helping young families pay down debt and live financially free. Mark has a Bachelor’s degree in financial management and a Master’s degree in economics and finance. He is a husband of one and father of two and calls St. Louis, MO, home. He also loves playing in old man baseball leagues, working out, and being anywhere near the water. Mark has been featured in Yahoo! Finance, NerdWallet, and the Plutus Awards Showcase.
Gwen @ Fiery Millennials says
Note to self: have my partner be on my insurance, not theirs. It’s not necessarily a huge issue because I’m the lady with the good health insurance, but what a mess! Thanks for the PSA on what to do, and what not to do, with insurance! Good thing you escaped this mess with the first birth!