How does Medi-Cal work as secondary health insurance?
My husband and I are both unemployed in Northern California. We’re not retirement age yet and are looking for jobs. Our COBRA health insurance ended 3/31/2022. Covered California told us that we are eligible for health coverage through Medi-Cal but not Covered California. We were approved for coverage by Medi-Cal effective 4/1/2022. Unfortunately, none of our long-term doctors accept Medi-Cal so we decided to purchase a separate family health plan directly from Anthem Blue Cross. That coverage was effective 4/1/2022 so no lapse in coverage.
Our Medi-Cal Health Services advisor encouraged us to choose a health plan with Medi-Cal anyway as secondary insurance. In particular, just in case we need emergency or hospital services and for prescriptions.
How would secondary insurance work in this case? My understanding so far is this: 1. Health services would first be billed to our primary insurance Anthem Blue Cross. 2. IF the provider accepts Medi-Cal, then Medi-Cal would be billed as secondary insurance for any amounts not paid by the primary insurance. 2a. Does that mean that if the provider accepts Medi-Cal, then any charges that would go against our calendar deductible (copays, co-insurance, amts not covered, etc.) could be billed to Medi-Cal as secondary insurance? 2b. Am I supposed to notify my Anthem Family plan insurance that I have Medi-Cal as secondary insurance? If so, who do I contact? 2c. Do I just let my doctor’s office know that I’m covered by my Anthem Family plan as primary coverage with Medi-Cal as secondary coverage so they can bill both insurances or do I have to take action for claims? 3. If the provider does NOT accept Medi-Cal, then claims can’t be made to Medi-Cal as secondary insurance? 4. For example, a monthly prescription has a $10 copay through my family Anthem Blue Cross primary insurance. The Rx would be billed to Anthem BC first then the pharmacy would bill Medi-Cal for the $10 copay amount? 5. Is it possible that there’d be a conflict between what’s paid by my Anthem Family plan and what’s paid by Medi-Cal? Might the Anthem Family plan ask to be reimbursed if Medi-Cal is covering a service? 6. Would it be better to just waive Medi-Cal coverage?
My head is swimming with trying to figure this all out. Any advice would be appreciated!
submitted by /u/tessalata
[link] [comments]How does Medi-Cal work as secondary health insurance? My husband and I are both unemployed in Northern California. We’re not retirement age yet and are looking for jobs. Our COBRA health insurance ended 3/31/2022. Covered California told us that we are eligible for health coverage through Medi-Cal but not Covered California. We were approved for coverage by Medi-Cal effective 4/1/2022. Unfortunately, none of our long-term doctors accept Medi-Cal so we decided to purchase a separate family health plan directly from Anthem Blue Cross. That coverage was effective 4/1/2022 so no lapse in coverage. Our Medi-Cal Health Services advisor encouraged us to choose a health plan with Medi-Cal anyway as secondary insurance. In particular, just in case we need emergency or hospital services and for prescriptions. How would secondary insurance work in this case? My understanding so far is this: 1. Health services would first be billed to our primary insurance Anthem Blue Cross. 2. IF the provider accepts Medi-Cal, then Medi-Cal would be billed as secondary insurance for any amounts not paid by the primary insurance. 2a. Does that mean that if the provider accepts Medi-Cal, then any charges that would go against our calendar deductible (copays, co-insurance, amts not covered, etc.) could be billed to Medi-Cal as secondary insurance? 2b. Am I supposed to notify my Anthem Family plan insurance that I have Medi-Cal as secondary insurance? If so, who do I contact? 2c. Do I just let my doctor’s office know that I’m covered by my Anthem Family plan as primary coverage with Medi-Cal as secondary coverage so they can bill both insurances or do I have to take action for claims? 3. If the provider does NOT accept Medi-Cal, then claims can’t be made to Medi-Cal as secondary insurance? 4. For example, a monthly prescription has a $10 copay through my family Anthem Blue Cross primary insurance. The Rx would be billed to Anthem BC first then the pharmacy would bill Medi-Cal for the $10 copay amount? 5. Is it possible that there’d be a conflict between what’s paid by my Anthem Family plan and what’s paid by Medi-Cal? Might the Anthem Family plan ask to be reimbursed if Medi-Cal is covering a service? 6. Would it be better to just waive Medi-Cal coverage? My head is swimming with trying to figure this all out. Any advice would be appreciated! submitted by /u/tessalata [link] [comments]Read Morer/HealthInsurance