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Health insurance primary (thur my work) and secondary (medicare advantage plan)?
Written By: admin on March 5, 2010
2 Comments
I have health care insurance through my work for my wife and myself. My wife also has Secure Horizons medicare advantage plot because she’s disabled. Can the two insurances work together and how or should I do away with the medicare advantage plot and save the $90+ ammonth?
My employeer plot is Cigna PPO, with all of our doctors being in the network. So all we have to deal with typically is co-pays. With some of my wifes new treatments I’m not wanting to run into the problem of picking up the full tab on things that may not be covered by my primary. I guess my question is: How do I make the two work together? Assuming that theres going to be alot of Out of Pocket costs.
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Tags: Advantage, alot, cigna, cigna ppo, doctors, health, health care insurance, insurance, insurances, medicare, Plan, primary, secondary, secure horizons medicare, secure horizons medicare advantage, secure horizons medicare advantage plan, thur, work
They can work together, but my question is how much does your work coverage leave you paying if you don’t use hers. If its less than 90 a month then get rid of the Secure Horizons. If its more then keeps it and use it as a secondary insurance which mean it will cover most if not all that your primary does not cover. I see it all the time at work.
It’s not Secure Horizons that has the premium; most Secure Horizons plans have a $0 premium. It is Medicare Part B that has the $96.40 premium.
Secure Horizons has several different types of Medicare Advantage plans. The most common is an HMO but they also have a PPO and a PFFS plot depending on your area. The HMO & PPO have doctor networks, the PFFS does not.
If she has the HMO the Cigna doctor must be in the network or S.H. won’t pay anything. If it is a PPO it may or may not pay anything; it will depend on if the Cigna doctor is in the network and what the procedures are. S.H will coordinate the benefits with the PPO if the doctor is in network but may not pay out because of what Cigna has already paid. If it is the PFFS the doctor must be willing to accept the plot but again it will depend on the procedure whether or not it will pay.
You will have to talk with both the Cigna and the Secure Horizons agents. If you give up S.H. it won’t save you any money. You must also give up Medicare Part B and depending on your current plot and her particular situation that may or may not be simple to do. You’d have to contact Medicare or your S.H. agent for guidance.
If you give up Part B she’ll still have Medicare Part A which may help pay for hospitalization after a $1024 out-of-pocket deductible.