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Approval If You Have Other Coverage

If you or a covered dependent are in another benefit plan and the MILA National Health Plan is the patient’s secondary coverage, approval works as follows:

  • If the other plan requires continued stay review and/or advance approval — just as the MILA National Health Plan does — then the other plan’s approval satisfies the MILA National Health Plan’s requirement for approval. You do not need additional approval from the MILA National Health Plan.
  • If the other plan does not require a review or advance approval and MILA does, you must obtain advance approval from a MILA National Health Plan care coordinator to qualify for maximum benefit coverage.
  • If Medicare is your primary plan and it covers the procedure, no prior approval is required from the MILA National Health Plan.

For additional information about how benefits are coordinated when you are covered by another benefit plan, see here.