Insurance?

[audette]

So, DH and I are trying to figure out insurance things...

First - DH is retired military.  Up until recently, Tricare (for retirees) was our only option for insurance.  It's pretty decent, we're in a Prime service area, and we love the primary care manager we are assigned to at the base clinic.  Specialty services are sometimes a bear in this area, which has caused me a few headaches because Humana (managing tricare services here) has an incredibly horrible database of providers.  DH doesn't really need specialty care, so it's not something he's run into much.


I started a new job on Monday.  And, the new employer offers a high deductible plan.  The cost works out to pretty much nil if I elect to have just me covered (for those eligible for an HSA, they toss money into it, and for those like me, not HSA-eligible, they simple pay a comparable amount on my paycheck, which just happens to pretty much cover the portion of the plan cost for me).  The costs to cover DH as well as me are a bit more, but not horrible.


Does anyone here have experience navigating being dually-insured?  How the heck does it work?  I mean, I know in theory, the doctor's office will bill my primary insurance, and then bill my secondary insurance, but will it otherwise limit my ability to do anything?  Does this process of having to bill two insurance companies lead to stupid headaches normally?  It's already at the point with Tricare that most doc's offices are of the opinion that they can't understand what my copayment is, so they just send me a bill for my copayment after getting payment from Tricare, so I suspect this will probably just lengthen how that process works for me...

[Deleted]

Nov 30, 2019 23:08:31 GMT -5 audette said:

So, DH and I are trying to figure out insurance things...

First - DH is retired military.  Up until recently, Tricare (for retirees) was our only option for insurance.  It's pretty decent, we're in a Prime service area, and we love the primary care manager we are assigned to at the base clinic.  Specialty services are sometimes a bear in this area, which has caused me a few headaches because Humana (managing tricare services here) has an incredibly horrible database of providers.  DH doesn't really need specialty care, so it's not something he's run into much.


I started a new job on Monday.  And, the new employer offers a high deductible plan.  The cost works out to pretty much nil if I elect to have just me covered (for those eligible for an HSA, they toss money into it, and for those like me, not HSA-eligible, they simple pay a comparable amount on my paycheck, which just happens to pretty much cover the portion of the plan cost for me).  The costs to cover DH as well as me are a bit more, but not horrible.


Does anyone here have experience navigating being dually-insured?  How the heck does it work?  I mean, I know in theory, the doctor's office will bill my primary insurance, and then bill my secondary insurance, but will it otherwise limit my ability to do anything?  Does this process of having to bill two insurance companies lead to stupid headaches normally?  It's already at the point with Tricare that most doc's offices are of the opinion that they can't understand what my copayment is, so they just send me a bill for my copayment after getting payment from Tricare, so I suspect this will probably just lengthen how that process works for me...

Not sure if it’s the same for Tricare for retirees, but for AD they will always bill the non-Tricare insurance first. It would be worth trying to call a Tricare representative to ask how this would work if you had a HDHP.

[audette]

Dec 1, 2019 3:10:17 GMT -5 @villainv said:

Nov 30, 2019 23:08:31 GMT -5 audette said:

So, DH and I are trying to figure out insurance things...

First - DH is retired military.  Up until recently, Tricare (for retirees) was our only option for insurance.  It's pretty decent, we're in a Prime service area, and we love the primary care manager we are assigned to at the base clinic.  Specialty services are sometimes a bear in this area, which has caused me a few headaches because Humana (managing tricare services here) has an incredibly horrible database of providers.  DH doesn't really need specialty care, so it's not something he's run into much.


I started a new job on Monday.  And, the new employer offers a high deductible plan.  The cost works out to pretty much nil if I elect to have just me covered (for those eligible for an HSA, they toss money into it, and for those like me, not HSA-eligible, they simple pay a comparable amount on my paycheck, which just happens to pretty much cover the portion of the plan cost for me).  The costs to cover DH as well as me are a bit more, but not horrible.


Does anyone here have experience navigating being dually-insured?  How the heck does it work?  I mean, I know in theory, the doctor's office will bill my primary insurance, and then bill my secondary insurance, but will it otherwise limit my ability to do anything?  Does this process of having to bill two insurance companies lead to stupid headaches normally?  It's already at the point with Tricare that most doc's offices are of the opinion that they can't understand what my copayment is, so they just send me a bill for my copayment after getting payment from Tricare, so I suspect this will probably just lengthen how that process works for me...

Not sure if it’s the same for Tricare for retirees, but for AD they will always bill the non-Tricare insurance first. It would be worth trying to call a Tricare representative to ask how this would work if you had a HDHP.

I spoke with a Tricare rep last week, and let's just say their information was, uh, underwhelming in detail... 

I think it works the same for retirees - Tricare is secondary, so the primary insurance is billed first.  How that works for a HDHP is a whole other ball of wax.  Do charges that Tricare pays count toward the annual deductible on the HDHP?  If not, I'll pretty much never make it to the deductible in the work plan.

[mich1]

Personally, I have found it a royal pain.

I have Medicare through disability, and DH’s BCBS through his employer. I do not have a Medigap plan, as my local choices suck because I am on disability. If I was disabled and 65, this changes and I would have access to better plans.

What has happened in the last couple years is that Medicare says BCBS should pay, and BCBS says Medicare should pay. BCBS should be my primary, but they keep denying it. They owe my PT about $3000 now, as they have not paid her a dime since I started going. Now they are trying to claw back $$ that they have NOT paid her on my behalf!

In the meantime, despite having a Cadillac plan plus Medicare, I have been the only one paying the bills! This really does suck, if I was not in this position of needing something, I would bail.