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Dual Health Insurance Question
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Ang-Rich
Beyond Compare
Member since 5/05 17988 total posts
Name:
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Dual Health Insurance Question
DH and I were/are on his medical and dental plan but my new plan just kicked in. We can't come off of his until December 1 so right now we have two medical plans.
Two questions:
1. Could this cause a problem for us in terms of benefits...like if one finds out we have another can they reduce or change our benefits?
2. Can we use both plans at one time...for example...if the dental plan for basic is 80/20 can we have one insurance cover the 80 and the other cover the 20 so that we don't pay?
Anyone ever deal with this before?
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Posted 11/14/06 10:21 AM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
Shorty
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Member since 5/05 30390 total posts
Name:
really
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Re: Dual Health Insurance Question
USUALLY its done by the birthday rule...
whoever's birthday is earlier in the year is the primary insurance
ex: your birthday is march, DH is sept --- your insurance is primary.
I would call both companies and coordinate the benefits. One may reimburse the other's copay, etc.
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| Posted 11/14/06 10:26 AM |
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MikesWife
Wanting...........
Member since 1/06 6887 total posts
Name:
Karen
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Re: Dual Health Insurance Question
I thought that you were the primary on your OWN insurance and secondary on your spouses and vice versa.......hmmm...
Sorry I'm not helping....
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| Posted 11/14/06 10:27 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Dual Health Insurance Question
Yes, it's called coordination of benefits. Each of your plans will be primary for you and secondary for the other.
So if you have a claim that your company pays 80% on, your DH's plan will cover the rest of reasonable and customary charges.
We have this with our dental plan. I was going to also go onto DH's plan as secondary insurance but with his plan the coverage is not so good so not worth the additional premiums.
Coordination of benefits is really good if you are both on each other's dental plan since dental plans tend to have limited benefits with limited annual maximums.
Also, if you know you are going to have surgery or a procedure that your company will only cover at 70 or 80% the secondary plan will pick up the balance. This is especially significant if you have to go out of network.
You have to weigh and measure whether paying the extra premiums each month are worth the benefit.
Seems like you are stuck for now, but that's the info. It's not necessarily a bad thing.
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| Posted 11/14/06 10:28 AM |
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Ang-Rich
Beyond Compare
Member since 5/05 17988 total posts
Name:
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Re: Dual Health Insurance Question
Thanks everyone! This is very helpful and now I think I understand it a lot better. DH's HR person is calling their plan to find out the primary insurance rule.
Thanks again!!!! 
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| Posted 11/14/06 10:37 AM |
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PrincessP
Big sister!!!!!!!!!!
Member since 12/05 17450 total posts
Name:
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Re: Dual Health Insurance Question
Posted by Shorty
USUALLY its done by the birthday rule...
whoever's birthday is earlier in the year is the primary insurance
ex: your birthday is march, DH is sept --- your insurance is primary.
I would call both companies and coordinate the benefits. One may reimburse the other's copay, etc.
I heard of the b-day rule too but I think it applies to the kids. They told me when my baby is born the b-day rule will apply to whoevers insurance policy covers the baby. I think that primary is your own and secondary is your spouses.
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| Posted 11/14/06 11:46 AM |
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