maybe odd insurance question

[ans]

Hi. I'm a newbie contemplating ADR.

My primary, Empire Health Choice has ok'd a two-level replacement although the fine print says they can review this; thus, I'd have to put money up front for my surgeon due to uncertainty.

My secondary, BC of CA (group ppo thru a university) won't tell me if Utilization Review pays for ADR. I know BC is w/Aetna (or was) is holding out, but my surgeon's office says "maybe".

My sense is not to depend at all on my secondary - esp. since it's not a private plan, 'tho a group PPO.

Does anyone think that I'm on-target in not counting on my secondary?

Thanking in advance and very happy to have discovered this place.

Sincerely, ans

[Patrick]

I think you are on track about not counting on a secondary insurance. In fact, I wouldn't even count on your primary insurance according to the small print on the bottom.

What exactly does "they can review this" mean? I would tell them if they want to "review" it, then "review" it before your day of surgery.

Who and where did you find your surgeon to do a two level?