rattle28mp
Junior Member
What is the name of your state (only U.S. law)? NY
Hello
I’m currently a retired federal employee. I kept the FEHB health insurance which is UHC Consumer Driven Plan option with employer (or ex-employer now) who grants a yearly HRA sum of $2400 for self plus one. After I exhaust this HRA amount I have to pay out of pocket until I meet the plan’s deductible of $3600. After I reach the $3600 deductible the plan becomes a regular fee for service plan with copays and coinsurances. This is my primary insurance.
I also have Health insurance coverage through my husband’s employer which is also UHC regular fee for service with copays and co-insurance without an HRA. This is my secondary insurance.
I recently went to my doctor and after the service I received my EOB from my primary insurance. It stated that $245 was the amount billed by my doctor. Plan discounts were $21.72. I was responsible for $223.28. My HRA then paid this out of pocket expense of $223.28 since I still had money in the HRA and I had not met the deductible. I paid $0 myself and $223 went towards my deductible.
I would like to know how the coordination of benefits would work in this instance. Can I submit a claim to my secondary insurance so that they can reimburse the amount back to my HRA or at least get some sort of credit toward my secondary insurance deductible? Would my secondary insurance be responsible for anything?
Thank you.
Hello
I’m currently a retired federal employee. I kept the FEHB health insurance which is UHC Consumer Driven Plan option with employer (or ex-employer now) who grants a yearly HRA sum of $2400 for self plus one. After I exhaust this HRA amount I have to pay out of pocket until I meet the plan’s deductible of $3600. After I reach the $3600 deductible the plan becomes a regular fee for service plan with copays and coinsurances. This is my primary insurance.
I also have Health insurance coverage through my husband’s employer which is also UHC regular fee for service with copays and co-insurance without an HRA. This is my secondary insurance.
I recently went to my doctor and after the service I received my EOB from my primary insurance. It stated that $245 was the amount billed by my doctor. Plan discounts were $21.72. I was responsible for $223.28. My HRA then paid this out of pocket expense of $223.28 since I still had money in the HRA and I had not met the deductible. I paid $0 myself and $223 went towards my deductible.
I would like to know how the coordination of benefits would work in this instance. Can I submit a claim to my secondary insurance so that they can reimburse the amount back to my HRA or at least get some sort of credit toward my secondary insurance deductible? Would my secondary insurance be responsible for anything?
Thank you.