Author Topic: Primary and Secondary Deductibles  (Read 6797 times)

LizAN

  • Sr. Member
  • ****
  • Posts: 354
Primary and Secondary Deductibles
« on: June 10, 2012, 11:42:50 am »
Has anyone who had surgery with HEI had two different insurance policies with very different deductibles?

House is telling me I will have to pay them the higher deductible ($3500) up front, because it is on my primary policy.  I think my secondary policy will end up paying the difference, as that deductible is only $500, and then I will have to try to get $3000 back from House.  The deductible on my primary policy is higher than my annual maximum out-of-pocket on my secondary policy.

I would drop my primary policy (BCBS) except that is has hearing aid coverage and my secondary (Great West/CIGNA) does not.

Liz
8/20/2010 - 9mm AN on left side 
Fullness, tinnitus, mild hearing loss
2/20/2011 - 8mm
4/20/2012 - 12.4 mm
Moderate to severe hearing loss, LOUD tinnitus, deteriorating balance
Facial numbness and twitching, which subsided pre-surgery
Translab at House, 7/3/2012, Slattery and Schwartz

arizonajack

  • Hero Member
  • *****
  • Posts: 1140
  • Arizona - It's a Dry Heat
Re: Primary and Secondary Deductibles
« Reply #1 on: June 11, 2012, 05:25:40 pm »
If you haven't done so already, I strongly suggest that you sit down and carefully and thoroughly read your policies and become familiar with the terms and conditions.

I believe that if you pay the $3500 deductible to House then your secondary policy should reimburse you directly when you provide them with a paid receipt.

Call the claims department of your secondary policy and find out how that works.

It's possible that House might be billing your primary carrier but not billing your secondary carrier. Check that, too.

If that's the case then you should need only have to submit your bills to the secondary carrier showing what's been billed and what's been paid by the primary carrier and what's been paid by you.

3/15/18 12mm x 6mm x5mm
9/21/16 12mm x 7mm x 5mm
3/23/15 12mm x 5.5mm x 4mm
3/13/14 12mm x 6mm x 4mm
8/1/13 14mm x 5mm x 4mm (Expected)
1/22/13 12mm x 3mm (Gamma Knife)
10/10/12 11mm x 4mm x 5mm
4/4/12 9mm x 4mm x 3mm (Diagnosis)

My story at: http://www.anausa.org/smf/index.php?topic=18287.0

LizAN

  • Sr. Member
  • ****
  • Posts: 354
Re: Primary and Secondary Deductibles
« Reply #2 on: June 11, 2012, 07:56:54 pm »
If you haven't done so already, I strongly suggest that you sit down and carefully and thoroughly read your policies and become familiar with the terms and conditions.

I believe that if you pay the $3500 deductible to House then your secondary policy should reimburse you directly when you provide them with a paid receipt.

Call the claims department of your secondary policy and find out how that works.

It's possible that House might be billing your primary carrier but not billing your secondary carrier. Check that, too.

If that's the case then you should need only have to submit your bills to the secondary carrier showing what's been billed and what's been paid by the primary carrier and what's been paid by you.

House is willing to bill both carriers, fortunately.  Unfortunately, I do not have $3500 to give them, up front.  Ain't happenin', so I hope they will work with me.   I already have a dialog going with my secondary policy company but it is taking forEVER to get any real answers from them...
8/20/2010 - 9mm AN on left side 
Fullness, tinnitus, mild hearing loss
2/20/2011 - 8mm
4/20/2012 - 12.4 mm
Moderate to severe hearing loss, LOUD tinnitus, deteriorating balance
Facial numbness and twitching, which subsided pre-surgery
Translab at House, 7/3/2012, Slattery and Schwartz