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  • Anyone here work with "Coordination of Benefits" ? HELP...

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    Old 01-10-2022, 07:58 AM   #1
    Tenacious
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    Question Anyone here work with "Coordination of Benefits" ? HELP...

    I posted my question under "Health Insurance"- but it seems that sub-forum is rarely clicked on, thought I might have better luck here.

    Is there ANYONE who understands how Coordination of Benefits work IF a husband & wife both carry the EXACT SAME BC/BS Highmark PPO plan ?

    Situation: My job pays for my Family plan, husband is getting a new Job and THIS is the Plan they offer, the exact same plan, it will cost him $300 a month to carry this plan, or $200 a month for him & kids.

    He used to have AETNA & it DID help up paying for some of what my Primary BC/BS didn't pick up.. but this is a different situation... will it cover ANYTHING being the exact same plan? We'd hate for him to pay up to $3,600 or out of his paycheck to find out that MY Policy totally cancels HIS policy out??

    I have called a BC/BS Rep -only to be told to call my HR Dept, she couldn't answer this question & supposedly sent my email on to someone else.. I called the Customer Support # at BC/BS only to get hung up on this morning .. so very frustrated.

    If anyone knows how this would work... please please leave a reply / send me a message.. I can find a zillion articles when you have 2 different Health plans..but I can't find 1 - if the health plans are the same .

     
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    Old 01-10-2022, 07:08 PM   #2
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    Re: Anyone here work with "Coordination of Benefits" ? HELP...

    I had this once but it wasn't Blue Cross and it was a while back. Only one plan would pay so we didn't pick up the other one. I would ask your HR department - or his - to give you the name and contact for the Blue Cross rep who handles their account - not the 800 number but the person who actually calls on them.

     
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    Old 01-10-2022, 10:14 PM   #3
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    Re: Anyone here work with "Coordination of Benefits" ? HELP...

    It seems everyone I talk to says something different. HR wasn't any help, didn't know, needs to send my email question to someone else. Bc/BS Rep told me to call HR.. I called today again, was put on hold, then hung up on !! It's so frustrating ! Though the little that Rep said, she DID say it would pick up as Secondary.

    I know from previous experience when it's a Different health plan ( when my Husband had Aetna).. it most certainly paid Extra and helped immensely as Secondary.. our daughter had a major surgery at age 14, in the hospital 5 nights and I never got a bill.. I don't know HOW this happened , it was like I had no deductible either.. My Primary BC/ BS & his Secondary Aetna was given ... it was Children's Hospital , if that makes any difference.. I doubt the hospital was just being Nice.

    Also when we had 2 insurances, many times it picked up the other half of my copays too.. at the Docs office, they would say..I wouldn't have to pay, if anything left, they'd bill me.

    So if it did this with Aetna.. I'm asking WHY would it be any different if its a 2nd BC/BS plan, it's still a different identification #?

     
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    Old 01-11-2022, 04:54 AM   #4
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    Re: Anyone here work with "Coordination of Benefits" ? HELP...

    I have no clue about this. If you can't get to the sales rep, i would call your state's insurance oversight office. OR call your doctor's practice manager and ask her/him what they do. That will probably tell you the most valid information!

     
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    Old 01-11-2022, 09:46 AM   #5
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    Re: Anyone here work with "Coordination of Benefits" ? HELP...

    Ok.. I got my answers today, in case this situation pertains to anyone else, as it can be awfully confusing..

    I talked to (3) people this am.... a Billing Lady at PCP office, a Lady in the "Coordinate of Benefits" Dept for BC/BS, and had a BC/BS Customer Service agent personally call me after I asked this question in my BC/BS app...

    They all verified that YES... if I get a Family Plan, basically that SECONDARY Insurance (even if the same type of BC/BS Plan), will help with Co-pays, if his Deductible is lower, that would help also, in the case I had a Hefty medical expense..

    I mean one must weigh the pros and cons of cost, if my husband pays $300 a month out of his pay for This Secondary plan and we have very little medical expenses, we lost money.. as that's $3,600 a year. (if he opts out, he only gets a credit for $2,400 I guess) It may be worth it, or it may not be worth it..

    One incentive on His plan is .. if we go to (2) local hospitals, it waives the co-pay and Deductible.. Sounds almost too good to be true, I think I may want to see how that works, with his being Secondary.. Last time we took son to the ER, ended up with a bill for $800 plus to put towards the Deductible.. would be great to see that waived.

     
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    Old 01-11-2022, 03:23 PM   #6
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    Re: Anyone here work with "Coordination of Benefits" ? HELP...

    Glad you finally got the information. Now you just have to decide if you want to spend $3600. Not knowing your income tax situation, it may not be wise. Can you put some in an HSA??? That might be a better option if you think you'll only need $1000 a year

     
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