Quote:
Originally Posted by Eagle Eye
Wife got Orthotics through her Chiro for $549, she sent it to her insurance company and they paid thier maximum of $300, leaving $249 for me to submit to my company. My company paid $200 out of the $249 as this was thier max. So in total we got $500 out of the $549.
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Quote:
Originally Posted by Eagle Eye
This is how it works now that we are with the same insurance company. She submits the $549 to hers and gets paid $300, it automatically gets submitted to mine, but the response is that they had already paid the max of $300 so no more would be available. So only $300 out of $549 is now paid.
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Quote:
Originally Posted by Northendzone
i hardly think that the insurance company is refusing to pay for a service.
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What would you call not paying out a claim?
Whatever you call it, the insurance company is trying to get out of paying for something the OP are covered for, by a plan that has been paid for. The fact that they are married has nothing to do with it because they are on different plans.
I don't see how this could be any more clear.