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Old 05-02-2019, 02:41 PM
 
28,666 posts, read 18,779,066 times
Reputation: 30944

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As far as I can tell from Humana (interface to Tricare for Life), I'm kind of screwed.

I have BC/BS from my current employer (until August, when I retire from them) which has a $2,500 annual deductible.

I'm also covered under Medicare, which has an $1,800 deductible.

And as well, I'm covered by Tricare-for-Life, which is essentially "medigap" coverage.

From what I can discern, if I did not have BC/BS, Medicare would be my first insurer and TFL would cover the Medicare deductible.

But because BC/BS is my first insurer, I'm responsible for their deductible and neither Medicare nor TFL will cover that. If that's true, I'm screwing myself royally having the BC/BS, because I'm in a period of needing multiple treatments this month and will have to spend the $2,500 BC/BS deductible out of pocket (not to mention the cost of the insurance itself).

Is that the experience anyone else has had?
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Old 05-03-2019, 08:20 PM
 
Location: Alexandria, VA, USA
1,110 posts, read 896,199 times
Reputation: 2517
You would think with three forms of insurance, you would be covered...

TRICARE pays last after Medicare and your other health insurance. Since you are still working, BC/BS pay first, then Medicare, then Tricare.

See this https://tricare.mil/Plans/OHI

https://blog.medicaremadeclear.com/b...-work-together

https://www.medicare.gov/supplements...ther-insurance

Call the Medicare Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627) if:

You have questions about who pays first
Your insurance changes

I would call them, don't ask us, we may not be giving you the best information. I think that you may be covered....

Good luck! BTW I would drop your BC/BS (or suspend it if you are in the government)
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Old 05-03-2019, 08:51 PM
 
28,666 posts, read 18,779,066 times
Reputation: 30944
Quote:
Originally Posted by rmm0484 View Post
You would think with three forms of insurance, you would be covered...

TRICARE pays last after Medicare and your other health insurance. Since you are still working, BC/BS pay first, then Medicare, then Tricare.

See this https://tricare.mil/Plans/OHI

https://blog.medicaremadeclear.com/b...-work-together

https://www.medicare.gov/supplements...ther-insurance

Call the Medicare Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627) if:

You have questions about who pays first
Your insurance changes

I would call them, don't ask us, we may not be giving you the best information. I think that you may be covered....

Good luck! BTW I would drop your BC/BS (or suspend it if you are in the government)
They have confirmed that I'm screwed. If I had only Medicare and TFL, I'd pay nothing for outpatient care and only the Medicare $1350 deductible for inpatient care.

But because of my employer BC/BS, I have to pay their deductable--$2,500--first before anything. Moreover, I'm also paying monthly for that coverage and can't get out this year. Until...

...I'll be retiring from the civilian job in a couple of months, and then I'll only have Medicare and TFL.
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Old 05-04-2019, 01:10 PM
 
Location: Hawaii/Alabama
2,270 posts, read 4,122,972 times
Reputation: 6612
Quote:
Originally Posted by Ralph_Kirk View Post
They have confirmed that I'm screwed. If I had only Medicare and TFL, I'd pay nothing for outpatient care and only the Medicare $1350 deductible for inpatient care.

But because of my employer BC/BS, I have to pay their deductable--$2,500--first before anything. Moreover, I'm also paying monthly for that coverage and can't get out this year. Until...

...I'll be retiring from the civilian job in a couple of months, and then I'll only have Medicare and TFL.
I am sorry for the spot you are in. As for the deductible I have never paid one and I was just inpatient a couple of months ago for 4 days (perhaps I have fallen between the bureaucratic cracks and I am not going to stick my head up!).
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Old 05-10-2019, 05:39 PM
 
Location: Alaska
532 posts, read 446,138 times
Reputation: 2152
Quote:
Originally Posted by Ralph_Kirk View Post
They have confirmed that I'm screwed. If I had only Medicare and TFL, I'd pay nothing for outpatient care and only the Medicare $1350 deductible for inpatient care.

But because of my employer BC/BS, I have to pay their deductable--$2,500--first before anything. Moreover, I'm also paying monthly for that coverage and can't get out this year. Until...

...I'll be retiring from the civilian job in a couple of months, and then I'll only have Medicare and TFL.
That sucks!

I'm 59, I have Tricare for retirees that I pay about $50/month for and I have had BC/BS for the last 4yrs, it's free from my employer.
They have worked pretty well together for me through several Ortho surgeries ER visits and PT. I have had zero copays and no deductible charges.

I am hoping TFL and medicare will work the same (no copays, no deductible)

I have found that the clinic and providers office that I go to will help out with expertise on who to bill first and then resubmitting to the 2nd insurance carrier.
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Old 05-10-2019, 08:29 PM
 
28,666 posts, read 18,779,066 times
Reputation: 30944
Quote:
Originally Posted by royalabran View Post
That sucks!

I'm 59, I have Tricare for retirees that I pay about $50/month for and I have had BC/BS for the last 4yrs, it's free from my employer.
They have worked pretty well together for me through several Ortho surgeries ER visits and PT. I have had zero copays and no deductible charges.

I am hoping TFL and medicare will work the same (no copays, no deductible)
Are you not paying deductibles because your BC/BS plan does not have deductibles, or is Tricare paying them for you?

Quote:
I have found that the clinic and providers office that I go to will help out with expertise on who to bill first and then resubmitting to the 2nd insurance carrier.

I have zero luck on that aspect.

At one point my doctor's office tried to claim they didn't take Tricare, but an elderly woman sitting there who overheard the conversation said, "Yes you do! You've been taking my husband's Tricare for years!"

I've had to go to this one imaging center three times in the last two months. We have the same debate every time about who pays first. Every time I have to call BC/BS, Medicare, and Tricare and put the same woman on the phone with each of them so she can hear from each of them what order they will pay.

In the last case, the Medicare guy actually said, "Alexis? I spoke to you on the 23rd and told you this same thing."
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Old 05-13-2019, 05:23 PM
 
Location: Alaska
532 posts, read 446,138 times
Reputation: 2152
Quote:
Originally Posted by Ralph_Kirk View Post
Are you not paying deductibles because your BC/BS plan does not have deductibles, or is Tricare paying them for you?

Hmm, guess I don't really know.
I don't think there is a BC/BS coverage without some kind of deductible. I have retired from that job so I don't have policy info or records to check.



I have zero luck on that aspect.

At one point my doctor's office tried to claim they didn't take Tricare, but an elderly woman sitting there who overheard the conversation said, "Yes you do! You've been taking my husband's Tricare for years!"

I've had to go to this one imaging center three times in the last two months. We have the same debate every time about who pays first. Every time I have to call BC/BS, Medicare, and Tricare and put the same woman on the phone with each of them so she can hear from each of them what order they will pay.

In the last case, the Medicare guy actually said, "Alexis? I spoke to you on the 23rd and told you this same thing."
Wow, pretty poor.
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