It might seem strange for some people at first glance but you can have 2 health insurance plans. This is actually something that is perfectly legal. Also, it is something that is highly recommended in some specific circumstances. Having primary and secondary health coverage can definitely be considered in the following situations:
- You are under 26 years old and you are covered through your employer or through your parents.
- You have separated married parents with different health plans. Both are listing you as being a dependent and you are younger than 26 years old.
- You are married and both you and your spouse are covered by health insurance offered by the employers.
- You are younger than 26 years old, are married, and are covered by the plans of your parents and your spouse.
- Medicaid coverage is received together with your health insurance plan.
Having Several Health Insurance Policies – How Does It Work?
When you have multiple insurance policies, it does not mean that you will be reimbursed two times when you need medication or you have to visit the doctor’s office. How much the plans cannot exceed the value of the treatment or consultation. This is possible through the concept of primary and secondary health insurance.
When you are covered by two health plans or more, benefits are coordinated and there is a way in which the insurance companies pay. Basically, a provider can be your main insurance and you can have another one as secondary. Here’s what you should know about these two:
- Primary Health Insurance – This is the main insurance plan you have. It will always spay up to its coverage limit. Cost sharing might be owed.
- Secondary Health Insurance – After the primary insurance policy paid the share it can, the rest of the bill is covered by the secondary insurance policy. This might cover all the cost that remains or just part of it and can even include life insurance.
There are all plan limits that apply to both insurance policies, the primary and the secondary one. After secondary insurance paid the share it can, you remain responsible for the rest that was not covered. This means that even in the event that you have several health insurances in place, it is still possible to have to pay some medical costs out of your pockets.
When you notice that your primary coverage is not enough and you are worried you will need to deal with several out-of-pocket costs, it is time to compare different health plans and shop around. US Health Group offers some of the best options on the market but you do want to look at all available so you can find the best deal for you.
Paying First – Primary Versus Secondary
Contrary to what you might believe, it is not always the primary insurance that will pay first. Who pays first will depend on the exact situation you are faced with.
As an example, when you are a minor and you have 2 parents who are covering you with family health insurance plans from US Health Group, the primary insurance provider is decided with the use of the birthday rule. Basically, this means that the parent who has the birthday firsts during the year will be the one with the primary health insurance. The age of the parent does not matter.
If any health insurance claim is made, the primary plan is going to act like no other plan exists. All benefits will be offered. Only after, the secondary plan will kick in to cover what remains, when it is necessary.
Is Paying Out-Of-Pocket Medical Costs Possible With 2 Health Insurance Plans?
When you are covered by several health policies, you need to pay all deductibles and premiums for the plans. The secondary health insurance is not going to count and pay the primary insurance’s deductible. Also, it is possible to owe out-of-pocket or cost sharing costs, like coinsurance or copayments.
It is important to note that when you have several health insurance policies, single plan rules do apply. As an example, when covered through a PPO (Preferred Provider Organization) insurance plan, the primary policy most likely has some provider network rules that have to be respected. Going to a provider outside the network means the primary health insurance is not going to cover how much you pay. The secondary insurance will also not cover you because you did not respect the rules of the primary plan. This is very important to remember.
Should You Get Two Health Insurance Policies?
Having more than a single health plan can have some benefits. You get more help when it comes to covering medical costs and you do not have to worry about becoming uninsured in the event that something unexpected happens, like losing your jobs.
With two or even more insurance plans, it is possible to get more coverage and to maximize your benefits. You would be able to be covered by the insurance policy of your spouse or parents without this costing them much. This is even true with some very beneficial employee-sponsored plans.
The only problem is having two policies or more does not automatically mean it is a certainty there will be no out-of-pocket expenses you have to deal with. Sometimes they do appear. Also, you will still remain responsible for cost sharing. This includes deductibles and premiums that apply to both of the health insurance plans.
Final Thoughts
In so many cases, it is confusing to understand when you need one or two plans to cover your medical needs. However, there is always assistance available in the event that you need it. All you really need to do is to discuss with an advisor and to conduct your own research.
Never agree to the first deal offered without at least checking those of the top health insurance firms in the country. You never know who has the best deal.