Does anyone have dual insurance?

[naughtoj]

I need to select my healthcare benefits. I am adding on my own insurance through my employer but I am already covered under hubby as well. This will give me 2 insurances. But I am confused as to how charges get covered. I know that everything is individual per plan as far as deductible, copays, coins, etc but I don't know if I should select on my primary insurance the $250.00/yr deductible option or the $1000.00/yr deductible option. With one insurance only I'd select 250.00, but how does it all work with 2?

Like for my D&C. My only insurance now (hubby's) has a $500.00 deductible. The procedure was covered at 80/10, so I ended up getting billed for almost 700.00, since I still had to meet the deductible. But if I had two insurances, wouldn't we still have to meet the deductible on the 2nd insurance before they would pay? Which, if so, would really mean I'd have to have a lot of health problems to ever really get my money's worth out of 2 insurances.

I am pregnant again and either way....if I end up with another D&C or a live baby, I figure I'll have more health costs this year. Is it worth it to have 2 insurances. My primary would cover 90/10 and my secondary 80/20. Would I still be paying something?

I don't know how much this matters since the cost to add this insurance is 5 bucks per paycheck for $1000.00 deductible and 15.00/pp for $250.00 deductible, but still...

Thanks for any help!

 

[Reese777]

Hi,

I have a family plan insurance for my family through my employer, but my hubby has his own "single" plan through HIS employer. His own insurance is considered his primary, and then mine is considered his secondary...I don't know if you'd have the choice of which to use first...maybe, maybe not...don't know. I know MY insurance wants to know each year if anyone else in the family is covered under a different plan. It comes in handy tho (I guess provided deductibles are met...) because if anything remains after one insurance looks at something, the other one is there and can pick up the rest. Hubby got sick with an infection one year and it was VERY expensive treatment (had LOTS of testing done) and insurance paid for EVERYTHING.

I think if I were in your shoes, I would call both companies and ask them how it works. I have also learned from experience to write down who you talk to, the date and time...that way if they dispute what you were told, you'll have something to refer back to.

Good luck!

 

[dlavie]

I believe they use who has the first birthday of the year as the primary. As long as they are not the same insurance company I don't think you'll have a problem just lots of paperwork.

 

[Jillster]

Definitely talk with your insurance rep. I learned the hard way that 2 insurances really equalled one. I thought 2 insurances was a good idea (why I don't know, I was in my 20's and never really used it anyway), and found out that each plan just covered a certain percentage of a procedure. Not one plan covering 80% and the other covering the remaining 20%. Oh well, I learned. Now if I could just have the 3 years worth of premiums I paid........

 

[Tamster]

In NYS, the subscriber's insurance is always primary, meaning your insurance would be primary for you and your husband's insurance would be considered secondary and your husband's insurance would be primary for him and your insurance would be considered secondary for him. The birthday rule applies for children...whomever's birthday is first is considered primary for the children...

 

[Sunshine 1528]

Your insurance will be primary and your DH's will be secondary.

Your birthday's would come in only for your children with dual coverage - then who ever had their birthday first in the calendar year would be primary.

 

[famousohara]

Sorry for such a late reply - didn't check the forum all weekend.

Your insurance plan would be primary on you and your husband's insurance would be considered the secondary payor. All rules for meeting deductible and coinsurance limits would apply. So if you need to meet a deductible on your plan as well as your DH's plan, then any services rendered to you would not be reimbursed by your husband's plan until deducible has been met under your insurance and his - basically you're adding your deductibles together.

In most cases, it is not financially beneficial to have two insurance plans unless one plan covers services not covered by the other plan. Or if your secondary coverage is significantly better than the primary coverage (very low or no deductible/coinsurance limits). And in many cases, if your primary insurance's allowable amount on a covered service is the same or greater than the allowable by your secondary plan - absolutely no additional payment will be made by the secondary. Your best bet is to talk this over with your HR rep or a contact at the insurer if you have one. They will help you calculate the cost benefits of taking on your own plan - if there are any.

Good luck with the process,

Mo