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c_crum | Question about carrying two Major Medical Insurance policies on 1 individual? |
My wife and I are having a kid and we both have HMOs from our individual employers. We both have high deductibles and ultimately similar coverage. A friend (who isn't in the insurance business) recommended we double insure our new born son when he arrives just to insure he is covered should he have health issues. Is this legal and does it make sense to do it? |
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thealphafemme
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Do you have a high-risk pregnancy? If not, then over insuring for the small probability that something goes wrong and you hit the maximum's on the insurance plan probably isn't the best financial decision if you are both paying extra premium to add dependents and if both of these plans are "high deductible" plans.
You can legally do it and it's called "Coordination of Benefits" (COB). The posters who have mentioned that one will be primary and one will be secondary (based on DOB of each spouse) are correct. You should also pay attention to the cost of your premium's vs. the cost of hitting the "high deductible" on both plans. That's potentially a LOT of out of pocket costs just to be "extra" insured.
The most important thing you are missing (IMO) however:
Is the doctor and hospital in which you plan to deliver covered by both plans networks? If not, then I wouldn't even consider it.
If they do both cover it, here's a quick example of how it can work. Let's assume that yours is primary and your wife's is secondary.
Each insurance company allows so much in charges by the doctor, so hypothetically let's assume your that a routine exam will be "allowed" up to $100.
Your doctor then charges $75.00 an office visit and you have a $15.00 co-pay each time. That will cover it because it's within the $100.00 "allowable charge" and you are still responsible for the co-pay.
Your wife's insurance will NOT pick up the co-pay and only comes in as secondary if the charges exceed the allowable charge and there is money still owed after both the primary insurance and you have paid your applicable charges... and that's assuming that the left over amount doesn't also exceed the secondary insurers' "allowable charge" which, in the spirit of insurance companies... is entirely possible and you can still be left holding the bill...
Hope that isn't too confusing and good luck with having a healthy baby!! |
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leaptad
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I think you'd find that, provided it's legal, your premiums will be so high that it won't even make sense. |
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Stumpy
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It is legal to do this and is not uncommon for people to have multiple insurance policies. The main thing to consider is what your anticipated out of pocket expenses may be for the child versus what the increase in premiums will be.
Say, for example, that your policy has an out of pocket max at $2000 but to add him to the second policy would increase its premium by $250 per month, then it would cost you $3000.00 just to carry the second policy (which would, in effect, pick up the amounts the first policy doesn't). So, it would cost you $2k max out of pocket for just one policy whereas having 2 policies would keep you from paying any medical expenses but would cost you $3k in additional premiums, so it wouldn't be worth it. |
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hro
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one will be primary the other secondary. i was told that whichever sposues birthday came first would be primary (however i am not sure that is correct) check with you insurance co.'s |
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hmark
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This can also be a difficult position as one ins co may wait until the other ins co pay out first. It is usually easier with one insurance company. You may find that they may both decline paying first, and you'll have to be on the phone with each to make sure it's paid. Both companies will not pay for the same item, so it would be a good idea to speak with one prior to your wife going into labor. |
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Q cumber
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go to the hospital and make sure they accept both insurance providers. The doctors office where I live does not accept patients with John Deere for some reason. |
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Andrea C
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Yes, you can do it, one will be secondary and one will be primary. You still have to pay deductibles and premiums for both though. I would say you are fine with just one insurance if you are comfortable with the coverage. The chances of needing both insurances is slim and God forbid if something is that wrong with the baby, you will probably qualify for help from the state to pick up what primary insurance won't cover. |
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Revolutionary
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Unless there is some high chance of disease in your child, this is not a good idea. I imagine your friend mentioned this because most health plans have a limit as to the total they will spend on a person, and your friend is thinking that, God forbid, something serious was wrong with your child, you could ensure that you did not run out of coverage.
I don't know the laws of your state, but I know that often one insurance will not kick in until another has been exhausted.
But if child has checked out normally through the process, I would not recommend the additional expenditure. Of course, if you can easily afford it, go right ahead. |
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vangorn2000
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Any individual can carry as many health insurance policies as they can afford, yes it is perfectly legal (my wife is included on my policy through my job, and also has her own through her job).
Most HMOs I know of cover 100% after you pay the deductible, so it doesn't make sense to have two of them unless you want to have two different doctors who might be able to refer you for special treatments in emergencies. |
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PraiseBob
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Watch out!!!!
What you are setting yourself up for is a scenario where each of the respective companies will deny coverage claiming that it is the other companies responsibility. |
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wish I were
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Yes add the child to both, what one does not pay the other will. |
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