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Joined: Apr 2004
Posts: 837
"Above & Beyond" Member (300+ posts)
"Above & Beyond" Member (300+ posts)

Joined: Apr 2004
Posts: 837
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


Tongue SCC (T2M0N0), poorly differentiated, diagnosed 3/89, partial glossectomy and neck dissection 4/89, radiation from early June to late August 1989
Joined: May 2006
Posts: 720
Likes: 1
"Above & Beyond" Member (500+ posts)
"Above & Beyond" Member (500+ posts)

Joined: May 2006
Posts: 720
Likes: 1
Cathy -- That's a great tip. Thanks.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
Joined: May 2002
Posts: 2,152
Patient Advocate (old timer, 2000 posts)
Patient Advocate (old timer, 2000 posts)

Joined: May 2002
Posts: 2,152
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


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
Joined: May 2006
Posts: 720
Likes: 1
"Above & Beyond" Member (500+ posts)
"Above & Beyond" Member (500+ posts)

Joined: May 2006
Posts: 720
Likes: 1
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. wink

cheers,
Leslie


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
Joined: May 2002
Posts: 2,152
Patient Advocate (old timer, 2000 posts)
Patient Advocate (old timer, 2000 posts)

Joined: May 2002
Posts: 2,152
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


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
Joined: May 2006
Posts: 720
Likes: 1
"Above & Beyond" Member (500+ posts)
"Above & Beyond" Member (500+ posts)

Joined: May 2006
Posts: 720
Likes: 1
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.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
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