Hi,

    I’m transgender and am looking to get facial feminization surgery covered under gender affirming care and while my primary insurance through my employer does not cover this procedure, I live in a state where it is mandated that any state sponsored insurance covers this procedure for trans individuals. My thought process is to take out a secondary state insurance health plan come November to cover an upcoming surgery I have in the spring of 2025. However, I’ve been reading a bit more on secondary insurance and it looks like I would have to get a denied EOB first and then the secondary would take care of it? Is that true or can I just submit the prior authorization with the secondary insurance and not have to worry about the primary? I’m also worried about this “non primary clause” I saw here. Some other questions are:

    -should I just drop my primary insurance through my employer and make the state insurance my primary? (It’s an expensive surgery so if it’s going to be a fight or a hassle with doing it through secondary I may just bite the bill and lay for out of pocket state insurance for all of 2025)
    -who should I be talking to about this? My primary insurance or should I call the state insurance? (Not with them yet so call support is limited)

    Will secondary insurance cover a surgical procedure that isn’t covered by primary insurance?
    byu/Bhanes2046 inInsurance



    Posted by Bhanes2046

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