Primary vs. Secondary Question (with HMO)

[mrs_hauntedskipper]

Hi Guys!

I've seen a lot of posts on Primary vs. secondary, but none about my specific situation.

My health insurance is an HMO with no out-of-network coverage.

I'm going to assume that there's no Cigna in the Caribbean.

Should I be getting primary or secondary travel insurance?

 

Thanks, as always for your patience and help!

[Host Caroline]

I would not "assume" with Cigna; since they are your HMO I would contact them directly since it's unlikely (?) that no one on this board works for Cigna and can give you a definitive answer. Get something in writing if possible (or name of agent/rep you speak with) as to exactly what they cover and where and then make your decision. My instinct based on past dealings w/ them is that they will not cover you on this cruise under the HMO so you need to get policy that provides "primary" coverage.

[sirwired]

To the OP: You'd have to call Cigna and ask them what their coverage was for international travel. Cigna may have agreements with foreign health providers. As far as primary vs. secondary: As long as a secondary policy doesn't require your personal insurance to cover part of the claim, in the end it doesn't matter which type you get.

 

Caroline: I'm going to have to disagree with you on a minor point: Most one-time travel insurance policies that act as a secondary carrier do not require your primary policy to cover anything. Many of them don't even require you to have primary coverage at all.

 

Annual medical policies have stricter rules on primary vs. secondary coverage (and many of them require you to have primary coverage), but one-time policies are usually written differently.

 

I think the primary vs. secondary debate is overblown. All it means is that if your travel insurance is secondary you need to wait for your primary carrier to reject your claim prior to filing with the travel insurance provider. I suppose the travel insurance being primary would knock a week or two off the total time it took to get your claim paid, but I'm not sure that is a feature I would spend extra to get.

[cruiseco]

My instinct based on past dealings w/ them is that they will not cover you on this cruise under the HMO so you need to get policy that provides "primary" coverage.

 

If the HMO is not covering, then ANY travel travel insurance policy is "primary." You can't be "secondary" unless there's some existing policy with "primary" standing.

[cruiseco]

I'm not sure that is a feature I would spend extra to get.

 

 

Amen to that, I think part of the confusiom is that travelers see "primary" and think that means they can just present their ID and be done with it -- the doctor will submit the bill directly to the insurer. It doesn't work that way.

[mrs_hauntedskipper]

Thanks for the answers, guys.

I took your advice and called Cigna. Found out that I'm covered for urgent or emergent issues overseas, so I know now I can go with secondary.

[klfrodo]

Here is my issue with Secondary vs. Primary. If I'm mistaken, please correct me.

As Secondary, I first have to file a claim with a company I know will most likely deny my claim. (I can't file directly with the travel insurance provider until officially denied by my personal insurance provider).

File the claim

A couple of weeks later,, we need more information.

A couple of weeks later,,, we need more information

A couple of weeks later,,, we lost that paperwork, can you resend it?

 

you get the drift

FINALLY DENIED

 

NOW you can finally file a claim with the right people to get the claim satisfied.

[sirwired]

Here is my issue with Secondary vs. Primary. If I'm mistaken, please correct me.

As Secondary, I first have to file a claim with a company I know will most likely deny my claim. (I can't file directly with the travel insurance provider until officially denied by my personal insurance provider).

File the claim

A couple of weeks later,, we need more information.

A couple of weeks later,,, we need more information

A couple of weeks later,,, we lost that paperwork, can you resend it?

 

you get the drift

FINALLY DENIED

 

NOW you can finally file a claim with the right people to get the claim satisfied.

 

If your personal policy doesn't cover overseas treatment, they won't go through two or three rounds of paperwork before they deny you; they should figure it out on the first try... If they do cover overseas treatment, but getting every claim paid is that much of struggle, find a new provider (or complain to your employer, as the case may be), as you have more insurance issues than who pays first on a travel claim.

[cruiseco]

Here is my issue with Secondary vs. Primary. If I'm mistaken, please correct me.

As Secondary, I first have to file a claim with a company I know will most likely deny my claim. (I can't file directly with the travel insurance provider until officially denied by my personal insurance provider).

File the claim

A couple of weeks later,, we need more information.

A couple of weeks later,,, we need more information

A couple of weeks later,,, we lost that paperwork, can you resend it?

 

you get the drift

FINALLY DENIED

 

NOW you can finally file a claim with the right people to get the claim satisfied.

 

In theory you may be correct. But in practice, any HMO is going to get out their big red DENIED rubber stamp and slap it on your claim about 2 minutes after opening the envelope.

[Host Caroline]

If the HMO is not covering, then ANY travel travel insurance policy is "primary." You can't be "secondary" unless there's some existing policy with "primary" standing.

 

that really is what I meant to say, it really is...:rolleyes:... just worded wrong.. dealt with this so much as TA but it's been 10 years, I'm older and retired and brain cells aren't as sharp

[CruisingGoddess]

I just wanted to share my experience. I have Cigna HMO as my medical insurance and bought a secondary travel insurance plan for our Asia cruise this past April. I had to see the ship doctor during our cruise and winded up with a $120 bill. I called the travel insurance company first and they said to file my claim with Cigna first so I did. Cigna paid for the entire bill, except for a $35 co-pay. I filed for reimbursement of the co-pay with the travel insurance along with Cigna's documents saying that is what I owed out of pocket. I got my $35 back (in addition to being reimbursed for trip interruption costs due to the Japan earthquake). Secondary insurance worked out really well in this case.