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How does duel insurance work?

my son has Cigna PPO through husband's employer. son was approved for SSI & given straight medi-cal. So now he has both insurances.

the PPO is obviously better but what do i use when i go to his doc? do i have to use medi-cal? do i have to say he has medi-cal? how does this work?

Answer Question

Asked by Anonymous at 10:56 AM on Dec. 27, 2012 in Health

Answers (7)
  • Both. Tell them to submit to the PPO first, and medi-cal second to cover what the PPO doesn't cover.

    Answer by idareyou at 11:03 AM on Dec. 27, 2012

  • I think, if he's eligible for both, you use the PPO as primary insurance and Medi-cal picks up the slack, such as co-pays, prescriptions that aren't covered by the PPO, etc. But your best bet to know for sure is to call...probably medi-cal and ask. I'd call medi-cal because the PPO might not know how medi-cal works, but medi-cal will be familiar (or should be, anyway) with how they work with other insurances.

    Answer by wendythewriter at 11:04 AM on Dec. 27, 2012

  • If you have any insurance through a job that becomes primary and the medi-cal will automatically become secondary. For my son, they basically pick up co pays when they are accepted.

    Answer by layh41407 at 11:10 AM on Dec. 27, 2012

  • Both. The ppo will be your primary, medical secondary. I deal with this with my oldest. The only problem for us has been finding providers who accept and will file both. But it's nice to have the secondary to pick up copays.

    Answer by missanc at 11:10 AM on Dec. 27, 2012

  • OP, you gave me my laugh for the morning, you know. Because when I read "duel insurance" I got this mental image of two guys in business suits with briefcases walking ten paces and then whirling around and throwing the briefcases at each other!

    "Dual" rather than "duel." I'm not trying to snark... it just gave me a giggle. You got great answers above!

    Answer by gdiamante at 11:53 AM on Dec. 27, 2012

  • In some states the don't give medicare cards if you have insurance, to avoid any and all problems call medi-cal and ask them, just to be safe, but if it is okay, you need to call his doctor and ask if they accept both and are willing to file both.

    Answer by jerseydiva at 2:37 PM on Dec. 27, 2012

  • You have to use the private insurance first and then Medi-Cal will pick up the rest (or whatever they will cover). The Medi-Cal will be secondary insurance.

    Answer by tyfry7496 at 6:44 PM on Dec. 28, 2012

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