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JenniferEver
The Disney Lady
Member since 5/05 18163 total posts
Name:
Jennifer
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Spinoff: Please explain secondary insurance to me.
I've never had secondary insurance before but FH is adding me to his plan as my secondary insurance.
I have a plan that works like this:
First $1000 of my care - they pay completely
Next $1000 of my care - I pay completely (deductible)
After that - Regular co-pay plan up to $3500 out of pocket.
Will the secondary insurance cover me during that $1000 deductible period? After that will it pay my co=pays? How does it work?
Thanks!!!
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Posted 11/20/07 11:47 AM  |
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JenniferEver
The Disney Lady
Member since 5/05 18163 total posts
Name:
Jennifer
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Re: Spinoff: Please explain secondary insurance to me.
Can someone please help me with this? I really want to understand it. Everyone keeps giving me "I guess" and "I think" answers. I know a lot of you have 2 insurances so maybe you can explain.
Thanks!
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| Posted 12/5/07 9:42 AM |
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LuckySV
LIF Adult
Member since 10/05 4675 total posts
Name:
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Re: Spinoff: Please explain secondary insurance to me.
You really have to contact the secondary insurance directly and find out what they'll cover. My mom has my dad's insurance as her secondary and it will pay her co-payments. So she pays nothing when she goes to any doctor. But when I was under my DH's as a secondary they would not pay my co-pays.
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| Posted 12/5/07 10:12 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Spinoff: Please explain secondary insurance to me.
I have never heard of a plan where the insurance picks up the first $1000 and then you have to pay $1000 and then a co-pay plan with an out of pocket of $3500.
Do you pay for the insurance?
Let's start there.
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| Posted 12/5/07 10:12 AM |
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JenniferEver
The Disney Lady
Member since 5/05 18163 total posts
Name:
Jennifer
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Re: Spinoff: Please explain secondary insurance to me.
Posted by Blu-ize
I have never heard of a plan where the insurance picks up the first $1000 and then you have to pay $1000 and then a co-pay plan with an out of pocket of $3500.
Do you pay for the insurance?
Let's start there.
It's a high-deductible plan with a FSA. I didn't get the FSA, since I'm hoping the secondary insurance will cover the deductible.
I've had that plan for most of this year, but FH's company policy changed and he can add me to his, so I want to take his as a secondary if it will pay for things in that deductible period.
What does secondary insurance normally cover?
And to answer your question, it's through my employer but I do have a contribution toward it.
I really think it's a sucky plan, but it was the only one that allowed me to go out of network, another choice was HMO and my doctors don't accept HMOs
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| Posted 12/5/07 10:18 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Spinoff: Please explain secondary insurance to me.
Is his plan better? I would just dump this plan. It sounds sucky.
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| Posted 12/5/07 10:46 AM |
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JenniferEver
The Disney Lady
Member since 5/05 18163 total posts
Name:
Jennifer
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Re: Spinoff: Please explain secondary insurance to me.
Posted by Blu-ize
Is his plan better? I would just dump this plan. It sounds sucky.
I believe is plan is a regular PPO so it is better, but I really want to keep mine in case he changes jobs or something. I hate him working a 100% travel job and told him we won't even discuss marriage until he has a job in NY... so hopefully at some point when he's been there long enough he'll be able to leave.
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| Posted 12/5/07 10:58 AM |
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CkGm
They get so big, so fast :(
Member since 5/05 13848 total posts
Name:
Christine
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Re: Spinoff: Please explain secondary insurance to me.
I have secondary insurance through my DH. I first have to go through my crappy insurance that denies claims to avoid paperwork. Thankfully my DH has Cigna so they just cover whatever my company denies. Its awesome. I was supposed to pay 2500 out of pocket for the birth of my DD and didn't pay a dime- his insurance covered it.
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| Posted 12/5/07 11:05 AM |
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CkGm
They get so big, so fast :(
Member since 5/05 13848 total posts
Name:
Christine
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Re: Spinoff: Please explain secondary insurance to me.
Posted by Blu-ize
Is his plan better? I would just dump this plan. It sounds sucky.
Most companies will make you go through your primary first. You cannot just drop it.
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| Posted 12/5/07 11:06 AM |
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Goldi0218
My miracles!
Member since 12/05 23902 total posts
Name:
Leslie
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Re: Spinoff: Please explain secondary insurance to me.
DH has better insurance than I do so he added me to his which will pick me up in January. I did not give up mine.
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| Posted 12/5/07 11:24 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Spinoff: Please explain secondary insurance to me.
Posted by CkGm
Posted by Blu-ize
Is his plan better? I would just dump this plan. It sounds sucky.
Most companies will make you go through your primary first. You cannot just drop it.
in most cases, if it's contributory, you can drop it. If it's non-contributory, you can't.
My DH dropped his though even though it was non-contributory. His plan also had a similar set up. I think it's crap.
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| Posted 12/5/07 11:38 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Spinoff: Please explain secondary insurance to me.
Posted by JenniferEver
Posted by Blu-ize
Is his plan better? I would just dump this plan. It sounds sucky.
I believe is plan is a regular PPO so it is better, but I really want to keep mine in case he changes jobs or something. I hate him working a 100% travel job and told him we won't even discuss marriage until he has a job in NY... so hopefully at some point when he's been there long enough he'll be able to leave.
If you lose coverage because he loses his job, you can sign up with your coverage again.
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| Posted 12/5/07 11:39 AM |
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charon54
My two boys!
Member since 5/05 7279 total posts
Name:
Rebecca
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Re: Spinoff: Please explain secondary insurance to me.
Posted by JenniferEver
Posted by Blu-ize
I have never heard of a plan where the insurance picks up the first $1000 and then you have to pay $1000 and then a co-pay plan with an out of pocket of $3500.
Do you pay for the insurance?
Let's start there.
It's a high-deductible plan with a FSA. I didn't get the FSA, since I'm hoping the secondary insurance will cover the deductible.
I've had that plan for most of this year, but FH's company policy changed and he can add me to his, so I want to take his as a secondary if it will pay for things in that deductible period.
What does secondary insurance normally cover?
And to answer your question, it's through my employer but I do have a contribution toward it.
I really think it's a sucky plan, but it was the only one that allowed me to go out of network, another choice was HMO and my doctors don't accept HMOs
It's called a Health Fund. I have the same plan (we work at the same place). For most people it actually works out really well. Basically during Phase one, you paid no copays, all expenses come out of the fund. During Phase 2, you pay the entire cost (after reduced to reasonable and customary charges). During Phase 3, you pay 10% of cost, they pay 90%, and during Phase 4, you pay 0%, they pay 100%. Each phase has a cutoff amount, which differs for me because I have my DH on it too.
It actually works out great for me, because I have few medical expenses, and you get to carry over any money left in your fund to the next year. So next year, I have an extra $1000 I am carrying over.
You can use any doctor on the Aetna Open Access/Open Choice network and you don't need referrals.
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| Posted 12/5/07 11:48 AM |
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JenniferEver
The Disney Lady
Member since 5/05 18163 total posts
Name:
Jennifer
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Re: Spinoff: Please explain secondary insurance to me.
It doesn't work out well for me at all. I blow through my healthfund in 2 seconds and certain drugs are alwyas covered at 90% (like my asthma meds) but some aren't (like my $250 a month in allergy meds). And it's really hard for me to come up with the $1000 deductible.
For people with no major health problems it's great, but I have severe allergies, asthma, back and neck problems, recuurent sinus infections, and on top of that I'm accident prone.
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| Posted 12/5/07 11:54 AM |
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