What is the name of your state (only U.S. law)? California
Hi, I am not sure how dual health insurance coverage works when my primary policy has a deductible of $2500 for everything other than office visits and prescriptions and my secondary policy has much better coverage without a deductible or with a low deductible. I don't know if I have to pay the $2500 deductible on my primary policy to access most of the services available to me without a deductible or with a much lower deductible.
The first policy is a high deductible PPO plan I would not be carrying if my second policy, a student health insurance plan, covered my monthly prescription costs adequately. With the exception of prescriptions, the student health insurance policy covers more, has no deductible for most services and charges a $200 deductible for services (specialists, tests and procedures) outside the university system. However, the university says it is secondary to any other health insurance policy I might carry. Again, the only reason I carry the "first" policy is because the university health system does not cover my prescription costs adequately - it caps prescriptions at $2000/year and my prescription costs run far higher (Unfortunately, a "prescription only plan is not an option for the medications on the primary policy).
More info:
For the last year and a half, I have been using "both" policies simultaneously - as if neither policy were primary. Despite the fact that the same insurance company provides both policies, I have not received any notice that I am doing something wrong. I get checkups and referrals to doctors outside of the system through the university policy, and buy my prescriptions with my other [what, should, in theory, be the primary] insurance policy. I realize I am not doing this correctly and that I will either pay far more, or far less, if I use the policies as intended under dual coverage. The same insurance company issues both policies (which are as different as one could possibly imagine).
Questions/Concerns - Please help
My concern is the $2500 deductible on my "primary" health insurance policy. Do I have to pay $2500 (or a portion of this deductible) before I can access services on my secondary policy that do not have a deductible, only have a $200 deductible, or are not covered under my primary policy? I cannot figure this out, and it's the reason I have not used the two policies as if I had dual coverage. This may not be an option any longer since I see a specialist (which I have paid for with the non-university policy, and the insurance company recently re-routed my claim on my "primary" policy back to the university (supposedly the secondary policy - they didn't send me anything about using my policies incorrectly however). I have been able to pick up my prescriptions as usual.
The big question is how does the large deductible on the primary policy affect my coverage and access to care under the secondary policy? If I did not have to carry the first policy to buy prescriptions each month, I would not have a huge deductible to satisfy before using what is covered by the university at a much lower cost (and for a few services, a much lower deductible). I don't want to ask the insurance company or the university since I have been using both policies without a problem for over a year. I will only have the university health insurance for 3 more months. If more information would be helpful, please let me know.
If you can only answer one question, the following would be most helpful to me:
To use my secondary policy (the university health system) for services that my primary policy charges a $2500 deductible, do I have to pay the deductible on the primary policy first?
If you don't know the answer, can you suggest a cheap, reliable/accurate source of information on this? As a graduate student with an chronic medical condition, I am low on funds.
Thank you in advance for any help you can provide.
Gratefully,
Sandy,
In California
Hi, I am not sure how dual health insurance coverage works when my primary policy has a deductible of $2500 for everything other than office visits and prescriptions and my secondary policy has much better coverage without a deductible or with a low deductible. I don't know if I have to pay the $2500 deductible on my primary policy to access most of the services available to me without a deductible or with a much lower deductible.
The first policy is a high deductible PPO plan I would not be carrying if my second policy, a student health insurance plan, covered my monthly prescription costs adequately. With the exception of prescriptions, the student health insurance policy covers more, has no deductible for most services and charges a $200 deductible for services (specialists, tests and procedures) outside the university system. However, the university says it is secondary to any other health insurance policy I might carry. Again, the only reason I carry the "first" policy is because the university health system does not cover my prescription costs adequately - it caps prescriptions at $2000/year and my prescription costs run far higher (Unfortunately, a "prescription only plan is not an option for the medications on the primary policy).
More info:
For the last year and a half, I have been using "both" policies simultaneously - as if neither policy were primary. Despite the fact that the same insurance company provides both policies, I have not received any notice that I am doing something wrong. I get checkups and referrals to doctors outside of the system through the university policy, and buy my prescriptions with my other [what, should, in theory, be the primary] insurance policy. I realize I am not doing this correctly and that I will either pay far more, or far less, if I use the policies as intended under dual coverage. The same insurance company issues both policies (which are as different as one could possibly imagine).
Questions/Concerns - Please help
My concern is the $2500 deductible on my "primary" health insurance policy. Do I have to pay $2500 (or a portion of this deductible) before I can access services on my secondary policy that do not have a deductible, only have a $200 deductible, or are not covered under my primary policy? I cannot figure this out, and it's the reason I have not used the two policies as if I had dual coverage. This may not be an option any longer since I see a specialist (which I have paid for with the non-university policy, and the insurance company recently re-routed my claim on my "primary" policy back to the university (supposedly the secondary policy - they didn't send me anything about using my policies incorrectly however). I have been able to pick up my prescriptions as usual.
The big question is how does the large deductible on the primary policy affect my coverage and access to care under the secondary policy? If I did not have to carry the first policy to buy prescriptions each month, I would not have a huge deductible to satisfy before using what is covered by the university at a much lower cost (and for a few services, a much lower deductible). I don't want to ask the insurance company or the university since I have been using both policies without a problem for over a year. I will only have the university health insurance for 3 more months. If more information would be helpful, please let me know.
If you can only answer one question, the following would be most helpful to me:
To use my secondary policy (the university health system) for services that my primary policy charges a $2500 deductible, do I have to pay the deductible on the primary policy first?
If you don't know the answer, can you suggest a cheap, reliable/accurate source of information on this? As a graduate student with an chronic medical condition, I am low on funds.
Thank you in advance for any help you can provide.
Gratefully,
Sandy,
In California
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