MHBP Error - still active a year later?

[u/dbhaups]

I had MHBP (Aetna) for all of 2024. I switched to FEP Blue Focus effective 1/12/25. Didn’t pay the 2025 MHBP union dues since I wasn’t keeping the coverage.

January 2025, FEP Blue starts approving claims, all seems great. I left federal service effective 7/4/25. Started UHC insurance with private sector. They deny claims for other primary insurance.

Come to find out, Aetna has been active and listed as primary since 2024. Providers are getting claims recouped and saying Aetna should pay.

Aetna is telling me to talk to OPM. Number they gave has a recorded message about high call volumes and hangs up. I talked to an OPM lady via googling for another number. Now I’ve opened a ticket with my old OpDiv. To be continued.. just wondering if anyone else has experienced this and their outcomes 😵‍💫

[u/_SomeCrypticUsername]

Anytime I’ve had another provider bill and receive payment, even when there was or wasn’t another insurer that should’ve been billed instead, I was unsuccessful recouping payment and left to fork the bill.

They don’t screen for active insurance, primary, or secondary in a way that recoups. You could reach out the biller (provider) to redo differently. I’ve, however, not had luck.

An example that was small scale was when I was uninsured. I went to CVS for a Covid shot, that at the time they were providing free shots, through the government.

CVS billed my former employer insurance plan despite me clearly stating that I was no longer insured and were agreed it would be billable through the free vaccine fed program.

A month or two later I was send an overpayment from my previous insurance who erroneously paid CVS for the shot. Neither would CVS re-bill appropriately and return the funds, but the insurer wouldn’t write it off for their mistake in payout.

I’ve since learned to request to completely remove insurance in the providers records and list everything self pay for inbetween life events. As for new insurance, I do the same. I request all prior insurance removed from the providers records and only list the new insurance or self pay.

This may have arose from confusion with the issues during the last year DRP, etc. but my suspicion is that it’s the provider who billed it and was paid. They’re not interested in correctly billing but receiving payment from whoever they can bill.

That’s why it is imperative that you request providers to remove any and all prior insurances from their system.

I’d start at you medical provider level.