I Need Help Navigating Health Insurance – Medicaid as Secondary Insurance

Please bear with me, the following is wordy and I probably have accidentally left out some necessary information, due to being a sleep deprived mother of a toddler. Here we go:

We live in Illinois for context. My husband’s job offers 2 insurance plans (PPO and High Deductible), both of which are quite expensive premiums and even the “low deductible” plan has a high deductible. Anyway, we elected for the PPO plan.

I am currently pregnant and qualify for Medicaid. As per the law, since my husband’s job offers insurance, his insurance has to be our primary and Medicaid is secondary.

I have had the same Primary Care Provider for 10+ years now, however he is not in network (Tier 1) of our primary insurance. If I continue to see him for my yearly physical, medication refills, etc. I know I will be paying more because he is in “Tier 2.” However, will Medicaid supplement the cost and pay the difference? I want to choose a BCBS Community Health Plan for my Medicaid plan, which my PCP is in network. So he is not in network for my primary, but is in network for secondary.

Now for my OBGYN visits. I prefer a certain group of doctors for my prenatal care. Similar to above, they are in-network with my secondary, but not in network for my primary, will I have to pay the difference? Do I need to choose a Medicaid plan that has only OBGYNs who I know are in my primary insurance’s Tier 1 network in order to not have to pay extra? I really do not like our primary insurance in network options for OBGYNs.

Lastly, how can I ensure that when I go to the hospital to deliver my baby, that all the doctors/services will be in network for both primary and secondary insurance?

TIA

submitted by /u/Hypochondirac101
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