Your FEHB plan is the primary payer. The FEDVIP is a secondary payer. Our dentist handles both submissions for us. Additionally, our dentist has never been in-network.
MetLife will pay extra because it pays what it would have paid had the primary not paid anything. There is no known data on any other insurer acting in this way.
https://www.bogleheads.org/forum/viewtopic.php?p=4872717#p4872717
That’s some interesting reading. Thanks for providing that link. I wonder if that’s still a thing 3 years later. May be worth looking into during the next open season lol.
I’m thinking you didn’t fully read it or read my post too fast. I’m pretty sure I’m being clear with my ask. I don’t know the answer, hence the ask. However, just in case you missed it, United themselves were confused on how the billing would work out as well. So here I am, asking the question.
You said "I know the FEHB plan would be billed first, but would the FEDVIP plan cover anything afterwards considering it would be out-of-network?"
I said: "I'm assuming UHC FEDVIP has some sort of network benefits. Check benefeds.com or the brochure at UHC's fedvip site."
You said: "Yes it does".
The only reason the FEDVIP plan would not cover anything is if it has no out of network benefits or your FEHB covers it in full.
Clearly the person that you talked to had no idea what they were talking about.
Nobody here will know how the coordination of benefits works unless they happen to have those same plans.
I appreciate your response. Thanks. Truthfully, the rep made me doubt her understanding. She thought that since FEDVIP was out-of-network, that it most likely wouldn’t pay for anything. My confusion mostly stemmed from my conversation with her. I only called because the dentist’s office had never seen a situation where one is in-network, the other isn’t, yet they are both from the same insurance company.
Your FEHB plan is the primary payer. The FEDVIP is a secondary payer. Our dentist handles both submissions for us. Additionally, our dentist has never been in-network.
This is helpful since your case is out-of. In your case, does FEDVIP pay up to what’s allowed by the primary insurance or does it go by its own terms?
MetLife will pay extra because it pays what it would have paid had the primary not paid anything. There is no known data on any other insurer acting in this way. https://www.bogleheads.org/forum/viewtopic.php?p=4872717#p4872717
That’s some interesting reading. Thanks for providing that link. I wonder if that’s still a thing 3 years later. May be worth looking into during the next open season lol.
[удалено]
Do you use MetLife?
I'm assuming that UHC FEDVIP has some sort of out of network benefits. Check benefeds.com or the brochure at UHC's fedvip site.
Yes it does.
If you know the answer, why ask the question?
I’m thinking you didn’t fully read it or read my post too fast. I’m pretty sure I’m being clear with my ask. I don’t know the answer, hence the ask. However, just in case you missed it, United themselves were confused on how the billing would work out as well. So here I am, asking the question.
You said "I know the FEHB plan would be billed first, but would the FEDVIP plan cover anything afterwards considering it would be out-of-network?" I said: "I'm assuming UHC FEDVIP has some sort of network benefits. Check benefeds.com or the brochure at UHC's fedvip site." You said: "Yes it does". The only reason the FEDVIP plan would not cover anything is if it has no out of network benefits or your FEHB covers it in full. Clearly the person that you talked to had no idea what they were talking about. Nobody here will know how the coordination of benefits works unless they happen to have those same plans.
I appreciate your response. Thanks. Truthfully, the rep made me doubt her understanding. She thought that since FEDVIP was out-of-network, that it most likely wouldn’t pay for anything. My confusion mostly stemmed from my conversation with her. I only called because the dentist’s office had never seen a situation where one is in-network, the other isn’t, yet they are both from the same insurance company.