Thanks to his observant dentist, my husband's SCC was caught at a very early stage (largely in situ, a little bit invasive) and was removed surgically with no additional treatment. He is getting regular checks at a CCC.

In a few weeks he is starting a new job, which of course comes with its own set of health benefits. He is now covered under my plan, which was better than his old job's and has been fine so far in terms of what it has paid for.

Given the possibility down the road of recurrence, is dual coverage worth the extra cost? (I would keep him on my policy; our children are also on my plan, so there is no saving involved in removing him.) Is significantly more paid for with two policies, or is it just an added expense with little added payback? Or are the hassles dealing with two insurance companies just too great?

If it helps, my insurance is BC/BS PPO and his would be Aetna PPO or QPOS. (He wouldn't go with the HMO options because he likes his current primary care doctor, who doesn't participate in the HMO plans offered.)

Thanks for any advice. Sorry to be repetitive of my posting just below -- I thought a more direct headline might elicit some responses.

Leslie,

I'm not sure I know enough to comment directly on the economics of those two policies (either by themselves or in combination). Howver, in the years since my treatment I was covered for quite a long time under an Aetna indemnity plan, and then (but not at the same time) by a BC/BS plan. What has been most important to me throughout has been having a plan where I had: 1)the greatest flexibility in keeping the doctors I had been dealing with, and 2) the fewest requirements for pre-approvals of procedures I was likely to need.

Since I've never been in the position of having two policies at once, I can't say for sure whether it could be worth it. I have long suspected, though, that if a person had coverage under two plans, it would simply provide each carrier with the opportunity to try to pass off coverage responsibilities to the other one, leaving the patient caught in the crossfire.

Cathy

I had the opportunity to get rid of my PPO Blue Cross policy when my wife became employed by Astra Zeneca, a pharma company that has a great coverage plan for their employees and spouses. I didn't. It isn't because the new plan doesn

Leslie,

I would make certain how the two insurances worked together. Many secondaries won't pay if the primary paid the same or more as they would have paid. I have had friends carry double insurance for years only to find the secondary was essentially useless. If his new company offers it, it can be more beneficial to have a flexible spending account to pick up deductibles and copays with pretax dollars. Just a thought.

Lisa

Having had dual coverage for a while, I can say that, at least in my case, there was no significant increase in coverage offered by having two policies, but a significant increase in paperwork hassles.
The minute you check the "yes" box beside the question Is this patient covered under another policy?, you must identify which policy is the Primary and which the secondary. And you don't get to decide.

At the time this happened to me, this was determined by the birthdates of the policy holders. First Birthdate of the calendar year is primary, so my wife's August birthday made her the Primary to my September.

Now, Doctors and Hospitals will handle the paperwork these days, but it may take an extended period of time to finally put the bills to bed.

I currently have dual coverage, Primary from my employer's BCBS PPO plan and Secondary through a military retirement. The secondary has paid NOTHING in the last 18 years since I retired. If it were my primary, it would be similar to a POC 80, but as a secondary it is pretty useless. Fortunately, there's no out of pocket cost for this "coverage" (Twenty one years in Nuclear Submarines was enough payment).

Will his new company insure him without exclusions for pre-existing conditions?

Most health and life insurance questionaires have the ubiquitous "Have you been diagnosed with or treated for?" questions which disqualify you for coverage of certain conditions.
As in Brian's case, it a tough choice to give up coverage you have in place, knowing that you might not be able to obtain coverage.
I hope I haven't muddied the waters here. Just trying to share my experience.

Good Health,

Chuck

Cathy and Chuck --

Thanks to you both for replying. It sounds like the hassles in dealing with two insurance companies -- and the expense of a second policy -- may outweigh any benefits we might obtain if he signed on for his own health insurance at his new job. Fortunately, I like my job and it has good insurance (better than his old job's, which is why we are all covered on my policy). Keep your fingers crossed that my industry, which has been going through some tough times of late, stays afloat for a while longer!

I don't know whether his new company's health insurance plan asks those questions, Chuck. I figured that since he had been covered under my policy, it wasn't a problem -- i.e., he could show continuous insurance coverage for the last five years and it wasn't like we were trying to put something over on the new company. In addition, the booklet we received about the new company's plans says nothing about pre-existing conditions and health insurance. It DOES talk about pre-existing conditions as they relate to the company's long-term disability and long-term care policies. He should be fine with both of those, as long as the fine print is as straightforward as the language in the booklet.

What is a POC 80?

Nuclear subs! I'm impressed. My son (just finished his first year of Navy ROTC) is at CORTRAMID in San Diego -- he has his sub week this coming week.

Lisa --

Yes, it does offer a flexible spending account. We have one through my job as well and it's been very useful (two root canals and several crowns, both new and replacement, for me alone this year -- getting older is such fun!). I will encourage him to sign up for that.

Brian --

That's why I was going to keep him on my policy. His new company has great insurance as well, but it's not worth the risk of dropping him from my plan, which has covered what has needed to be covered so far. I had planned to keep him on my plan and use that as the secondary coverage (his birthday comes before mine).

Assuming he CAN get health insurance at the new job, I was wondering if it is worth doing so. Based on what everyone has said, it doesn't sound like it. I wouldn't think there would be much difference in coverage between an Aetna PPO and a BC/BS PPO, though I would appreciate being corrected if I am wrong!

On a related topic, I'm wondering if this whole issue of insurance coverage essentially would keep me from moving on if an opportunity arises, since it's my job's insurance that has covered him so far. I really like what I do, but I've worked odd shifts for several years and there's not much prospect of that changing -- so I was beginning to think about investigating what else might be out there. If he can't get health insurance, though, I'll grin and bear it. (Yeah, yeah, it's all about ME!! )

Has anyone whose insurance has covered treatment changed jobs and had difficulties getting new coverage for the person who has been treated? Do health insurers consider the stage of the diagnosis when deciding about coverage (in situ vs a more advanced stage, for example), or are the words "squamous cell carcinoma" alone enough to sound alarms?

Thanks to you both for your responses. Sorry if I sound a bit dazed and confused in my ongoing questions.

-- Leslie

Leslie,
A POC 80 is a Point of Care 80/20 plan. Very similar to an HMO, in that all care is coordinated (controlled) through a Primary Care Physician. They pay 80% of UCR, (Usual, Customary, Reasonable), charges when I see a preferred provider, and I pay 20% of UCR. If I go out of network, they still pay 80% of UCR, but I pay everything else, with much higher deductables. It's not great insurance but it's better than no insurance.

Having the "C" word in your medical record is kind of like having a DWI on your driving record. The insurance companies want to see a clean record for at least five years before they are willing to take a chance on you. Health insurance is different in that patient confidentiality laws and state insurance laws make it more difficult for them, but it is still difficult to make decisions. I completely understand dazed and confused.

Good luck and Good Health,

Chuck

Leslie, just to add "fuel to the fire", I would suggest you talk -not to an Ins. co "customer rep"- but to the supervisor OR the owner of an Insurance Agency that sells that product before you make any changes. The "C" word does indeed change the way an Ins. Co. looks at you and not for the good. Amy

Thanks, Amy. I'm in touch with a former co-worker who has good contacts in the insurance community, and I plan to talk with someone who is not connected with the new company but is knowledgeable about what the new plan would be and how my husband's situation would affect his eligibility. At least he is covered under my plan, and will continue to be.

And thanks, Chuck, for your explanations. Sorry to hear that "dazed and confused" sticks around for a while, but I guess that's just the state of health care in the 21st century.

Leslie,

One other thing has been important to me in my coverage since cancer. My medical oncologist became my primary care physician right after my treatment ended, and ever since then I have made sure that any plan I participated in would allow that to continue. I still see him for follow-ups every 6 months or so, and he has coordinated the referrals to virtually every other specialist of any kind that I have needed to see.

Cathy

Cathy -- That's a great tip. Thanks.

Leslie,
Sorry I'm late on this but just back from vacation. I am covered by two insurance companies, Cigna PPO and BC/BS traditional, and my parents were covered by 3. My secondary covers whatever is not paid by my primary including copayments so I generally wind up paying nothing other than yearly deductible of the lowest policy. I generally have to submit bill and EOB to secondary because most providers, other than Medicare, will not bill secondary. If you are Medicare as my parents were, the bills are automatically sent to secondary and tertiary if anything left to be paid. I additonally have a flexible spending account which I used for drugs and uncovered dental expenses.

My secondary is free so well worth it. You need to calculate the cost vs what it will pay. Also, some policies have a lifetime max. so a secondary can be well worth it if you max out the first. It also gives you back up coverage for everyone should something happen to your job. Sometimes disabilty and health insurance are linked. Be sure to check that.

Just another man's opinion and experience.

Take care,
Eileen

Eileen --
Thanks for your reply. Nice to hear these policies CAN work together!

I'm still waiting to hear back from my former co-worker, the benefits expert. But unless my friend is dissuasive, my husband has decided to go ahead and get health insurance coverage for himself at his new job, assuming Aetna will accept him (we can show continuous coverage on my policy over the last five years). I have a flex account and he is getting one as well. He will also stay on my policy.

How do you get the secondary to pick up the cost of copayments for the primary policy? You must be an insurance wizard.

cheers,
Leslie

Hi Leslie,
I'm no insurance wizard, but I do suggest if the cost is not prohibitive that your husband cover himself only at his new job.

To get payment for anything not fully covered by his primary insurance, you simply zerox EOB from primary and bill from dr office (make certain they give you one with both diagnosis code and procedure code, this can sometimes be a hassle) and submit with form to secondary. If you are covered by secondary insurance, do NOT make any payments to primary hospital or anyone else until insurance denies it and you have exhausted all appeals if you feel they should pay. If they refuse to give you bill with codes that can be submitted for insurance, that is their problem. This is not your problem. You are insured. Tell the colllections agencies this and to go away.

Check your policies and the cost and the options and what they will pay as secondary. If he can get it without a health check and it is reasonable, I would take it depending on what your policy covers. You also need to check what your policy will cover if it is secondary for him and what the cost will be. I wouldn't change the kids.

Take care,
Eileen

Thanks, Eileen. Your suggestions are just what we are planning to do. My policy is BC/BS PPO and his new one (for himself only) would be Aetna PPO. The kids will remain on my policy.