Do you have to submit claim to all carriers?

[tranquility]

What is the name of your state (only U.S. law)? CA

If a person is covered by two insurance policies, do they have to submit a claim against both of them?

The reason I ask is that Ms. tranquility is very sick and is going into hospice. While I don't think her time is long, I am a planner and want to be prepared if I what I am praying for is the right thing and it is answered.

She is covered by her primary out-of-state Blue Cross and by her secondary in-state Blue Cross PPO policies. They each have 3 months of hospice care benefits and COB will provide no additional money during this time. Deductible and co-pay rules are annual and reset to zero at the end of the year.

Say the hospice claim is presented to either one or both policies. Then, Mrs. tranquility happens to live longer than the three month coverage period. If I then drop the primary coverage and the secondary coverage then becomes primary, would she be covered for an additional three months of benefits?

I'd like to best be able to frame the question before I call the secondary as I won't get a review unless I give them all information and I want to have a rough idea before going through all that work.

[ecmst12]

I'm so sorry to hear that

The first thing I would suggest is asking the primary coverage what they do if the patient ends up needing more then 3 months of hospice care. Is the 3 months a solid limit or can it be authorized for longer if needed? I say this because 3 months sounds like a pretty short limit for hospice, most of the policies I have seen allowed 6 months and some stated extension was possible beyond that if authorized and medically necessary.

As far as whether the secondary plan will count the first 3 months paid by the primary towards their own limit or not, that is something you will have to ask them. I couldn't begin to guess at the specific provisions of that specific plan.