Employed Senior Covered by Employer Health Plan Denied Claims

[PhillipT]

Was wondering if any other employed senior who is covered by their employer's health plan is being constantly denied claims by the primary insurance on grounds that the claim needs to be submitted to Medicare?

For four years now I have been constantly battling Cigna to reprocess claims that they say need to go through Medicare even though I keep pointing out that they are the primary insurance through my employment and that I do not have Medicare Part B.

It has already been noted by ProPublica that Cigna forces its doctors to randomly deny claims and was curious if this was another tack tick to deny claims. Are there other working seniors experiencing similar issues, either with Cigna or another company, denying claims on grounds that Medicare should be covering them?

PhillipT

 

[Flarbalard]

When denied, did you then submit a claim? Wouldn't the balance then fall under your insurance plan, subject to the usual limitations of the plan: is it covered, deductibles, and yearly out of pocket limits?

 

[C50]

Once you're on Medicare if your employer has less than 20 employees Medicare should be your primary insurance and your employers plan becomes secondary.