Double insurance coverage?

MissEm15

Does anyone have any experience/knowledge with this? I'm currently on DHs plan but now he's wanting me to look into being covered by my employer's insurance as well.. To save money on our twin delivery in January. I'm clueless abt how insurance works. I know his plan is a PPO & mine would be too. I'm curious how it works as far as the deductible too. Also, my company renews insurance in July.. So unless being pregnant makes me able to change status & add it, prob won't work anyway right? TIA!

michelle142

I'm not an expert, but I'm not sure that's even legal?

Where I work, my DH can't be on my insurance plan if he's offered insurance through his employer (he's not). So it wouldn't even be possible to be on 2 plans for us.

kefttsc

The birth of a baby is consider a "qualified event" and most policies allow you to change 31 days before and 60 days after a qualifying event.  So you can change it if you'd like.

You can't have two insurance companies as I understand it.  You probably could, but you'd be paying two premiums and two deductibles and that wouldn't be beneficial.

Time is up to get new coverage for January (yesterday was the deadline), but just call your insurance company (number on the back of your card) and they can provide a lot of guidance.  Even ask them the questions that you think are silly.  That's what they are there for.

MissEm15

I think it's legal from what I read so far. I can be on his plan even tho my company offers it.

misshart00

I believe you can have coinurance but I'm not any help after that. And I don't think you can change your insurance unless it's open enrollment time or a major life change (marriage, birth, etc.). I don't think they count pregnancy itself as a major life change.

crispywheats

You're best checking with your HR department. Everyone's plans and life change enrollment requirements are different.
With DH's insurance, we just have to add the baby within a month of his or her birth. I opted to not get coverage through my employer because in my case, it would automatically become my primary insurance and the coverage was far more expensive and not nearly as good.

PeaceofKia

I don't think you can have double full fledged insurance but I could be wrong...

usmcwife89

I have two health insurance companies. I have tricare because my husband is active duty. That's my primary health insurance. I also get health insurance from my job, and that's considered my secondary. For us- everything will be covered under our primary insurance provider luckily. Certain procedures and surgeries however are not covered by tricare. That's when the doctor/surgeon will bill tricare and when tricare kicks back a bill because they didn't cover it- the office then submits that to my secondary.

It's quite a pain because we pay monthly for both insurances. And for both there is deductibles and co-pays etc. I am dropping my secondary insurance through my work immediately come Jan 1 which is the soonest I am able to.

usmcwife89

Also with this whole new affordable care act.. It is my understanding you can only make changes and add new people to your plan (including yourself) at certain times of the year.

MissEm15

ChickenOnSunday said:

Now I've gone back and read for a second time what you wrote and I wonder if you can even get health insurance from your employer for yourself. If your enrollment period is July than you have missed that window for yourself.

A life changing event allows you to add someone to your plan outside of the enrollment period so if you already had the coverage than you could add the twins to your policy. That isn't the case here. I think you are "stuck" with only your husband's insurance until July 2015 but check with HR to be sure.

What is the cost difference between your plan and your husband's? Are either one of you able to add dependents w/o adding additional costs?

This is why I need to call I guess. It is def not open enrollment now & no both plans we have to pay to add dependents. DHs coverage is way better than mine for a cheaper price. I think he's thinking that it's still cheaper to pay two premiums per month until July (when Id un-enroll) I guess than $8k for delivery (which is us just preparing for the max it could be).

misshart00

MissEm15 said:

Now I've gone back and read for a second time what you wrote and I wonder if you can even get health insurance from your employer for yourself. If your enrollment period is July than you have missed that window for yourself.

A life changing event allows you to add someone to your plan outside of the enrollment period so if you already had the coverage than you could add the twins to your policy. That isn't the case here. I think you are "stuck" with only your husband's insurance until July 2015 but check with HR to be sure.

What is the cost difference between your plan and your husband's? Are either one of you able to add dependents w/o adding additional costs?

This is why I need to call I guess. It is def not open enrollment now & no both plans we have to pay to add dependents. DHs coverage is way better than mine for a cheaper price. I think he's thinking that it's still cheaper to pay two premiums per month until July (when Id un-enroll) I guess than $8k for delivery (which is us just preparing for the max it could be).

This is not related to your question, but I would call your insurance and ask a gazillion questions. What will be the copay of my hospital stay? What percentage of vaginal birth do you cover? C-section birth? What if its an emergency? Do you cover an epidural or other drugs? Etc, etc. you can find out pretty close to how much you will be paying out of pocket before ever going to the hospital. We did not do this with DD's birth and I'm still paying for the epi they didn't cover at all. This time, I called and talked to them for about half an hour and I know roughly how much I'll be paying.

chickyclg

I used to be covered under 2 policies, I had my own and we were planning on me leaving my job when we were going through the IVF process so when open enrollment came open for him he added me.  For us it didn't make a big difference because we worked for the same employer so essentially we had the same benefits.

mirigirl

I am covered under 3 insurance policies, and honestly anything more than 2 policies becomes a  PITA. The reason for these policies is because I am under 26 and am still on my fathers, step mothers, and mothers policies. However, once that ends, I will add myself to my DH insurance policy through his work. 

Having extra coverage has been great, but I still have deductibles and max OOP like others do. Like I said though, any more than 2 policies just gets confusing. My OB office decided to not even use my third insurance as it just adds more problems than it warrants. 

mirigirl

@chickenonsunday   My parents are still covering me because, it does not cost them any extra in their premiums to cover me. This is due to having other children on the policy. I am remaining on their policies until I am 26 because it will cost DH and I $600 a month to add me to his. I plan on being a SAHM once LO is born, so I will not have access to my own employer insurance. 

babybou3

I have worked in health insurance for a few years...you can have multiple policies. First check with your HR to determine if they consider pregnancy a life changing event. Most don't and Therefore you would not be able to start up the plan until open enrollment for the company. If HR will allow you to enroll now, your employer policy will become the primary policy followed by your spouses plan. I would find out what your plan covers as primary (such as 80% after ded and how much the ded is). After obtaining this information check with your spouses insurance to see how they pay on claims as secondary. If the policy is a non-duplication policy and also has 80% after ded, you will just be applying everything to both deductibles and not really getting a benefit for your money, as a non-dup plan doesn't pay an additional 80% of what is left. It goes off the initial total allowed, which will already be paid by the primary insurance, therefore the plan will not pay anything at all. Especially if the spouses plan has a higher ded and out of pocket maximum compared to your plan.

Maternity benefits to check when calling in include inpatient hospital stay - most plans will only cover room and board in a semi private room. Be prepared to pay the difference if you request a private room, 48 hours for normal vaginal delivery and 96 hours for CS. Also check your professional fees (this includes all treating physicians while inpatient including your OB). Optional ones to ask about are you lab benefits, circumcision, and if there is automatic coverage for the newborn or how long you have to contact your HR to add the newborn to the plan.

Sorry for the long reply.

PikoPiko

I think you need to be already enrolled for your employer's insurance in order to be allowed to make qualifying event changes to your coverage. Doesn't hurt to call and ask though.

---

I too can be double covered but chose not to.

DH and I both work for big corporations with really good insurance coverage, we used to have zero deductibles or copays. With the new health care taxes and such, both our companies now offer health plans with a high deductibles ($1500 and coinsurance 1000 for my plan).  If I'm double covered, my deductible would go up to $3000 for 2 people. DH is healthy and isn't burning deductibles.  I'd end up paying so much more to meet deductibles and coinsurance.

When the baby comes, he's going under my plan since I'd have already burned some of my deductible, closer to getting 100% insurance coverage. If he goes under both our plans, my insurance would not be primary because of the birthday rule.

I really do wonder if I'm looking at this wrong.

MapleMomma

I'm in the same boat as @mirigirl‌ and am double covered under my parents and my own policy. The only reason take coverage through work is because it is a better policy for DH and he is able to get paid an "opt out bonus" which covers the whole premium. My coverage through my parents if amazing though as I haven't paid a dime yet. They have other kids on the plan so it doesn't cost them any more.

As far as the qualifying event thing to take your coverage at work, they will only be able to enroll you effective the date of the birth of the baby.

Grapes13

I work in health and insurance and truly it just depends on the two plans if it will be beneficial for you. I have tricare as a primary through my husband, and a PPO with UHC through my employer. Tricare works a little different than most insurance plans so let me give you an example of how it might work for you. First of all you can only pick up your insurance under a qualified life event such as Annual enrollment, address change, marriage, loss of spouses employment, having a baby etc. so you probably won't be able to get on your plan early enough, unless your annual enrollment is now or before the end of the year ( most companies have theirs anywhere from oct.-dec.). Now two insurances are not always beneficial. Let's say your husbands plan covers 80% for most expenses (you'll want to look more specifically at the maternity and delivery section) and you pay 20% out of pocket after your deductible. That's a pretty standard plan. Then let's say you have a plan that covers 70% on some parts and 100% on other parts of the coverage. Whichever becomes your primary (probably your employers plan) will first be billed, once your deductible is met. Let's say it's billed something covered at 70%. After it pays it's part the insurance claim will go to your husbands plan and if it covers 80% it will pick up the other 10% and you still pay 20%.. If one of the plans covers something at 100% well you won't get a bill for that portion. Hopefully that made some sense to you. It can get tricky. Not always worth it to have two plans because generally you have deductibles on both that have to be met, and premiums you still pay each month. There are sometimes where it's worth it.. Me for example- I have tricare standard and it covers almost all of the delivery and maternity visits, costs, etc. But my doctor visits that are just primary care are only covered at 85%. Tricare doesn't cost me anything each month. I have my employers plan too which is a PPO and it covers 100% my primary care office visits but doesn't have quite as good of coverage for the baby stuff. It doesn't cost that much for me each month and my deductible is 150.00. (sooo cheap) so I choose to have both for the time being. HMO's are different but I won't go there lol! Hopefully this helped!

Grapes13

usmcwife89 said:

I have two health insurance companies. I have tricare because my husband is active duty. That's my primary health insurance. I also get health insurance from my job, and that's considered my secondary. For us- everything will be covered under our primary insurance provider luckily. Certain procedures and surgeries however are not covered by tricare. That's when the doctor/surgeon will bill tricare and when tricare kicks back a bill because they didn't cover it- the office then submits that to my secondary.

It's quite a pain because we pay monthly for both insurances. And for both there is deductibles and co-pays etc. I am dropping my secondary insurance through my work immediately come Jan 1 which is the soonest I am able to.

I wonder how you got tricare as your primary! My employer's plan had to be primary I was told... I guess it doesn't really matter that much, but perscriptions would be cheaper if tricare was my primary. Do you have standard or prime? I'm not in a prime location so that may be why they disnt let me make Tricare primary...

jezica125

Grapes13 said:

usmcwife89 said:

I have two health insurance companies. I have tricare because my husband is active duty. That's my primary health insurance. I also get health insurance from my job, and that's considered my secondary. For us- everything will be covered under our primary insurance provider luckily. Certain procedures and surgeries however are not covered by tricare. That's when the doctor/surgeon will bill tricare and when tricare kicks back a bill because they didn't cover it- the office then submits that to my secondary.

It's quite a pain because we pay monthly for both insurances. And for both there is deductibles and co-pays etc. I am dropping my secondary insurance through my work immediately come Jan 1 which is the soonest I am able to.

I wonder how you got tricare as your primary! My employer's plan had to be primary I was told... I guess it doesn't really matter that much, but perscriptions would be cheaper if tricare was my primary. Do you have standard or prime? I'm not in a prime location so that may be why they disnt let me make Tricare primary...

I work for an insurance company as well. Fyi it doesn't matter if your policy is secondary. You can still submit your drugs to your plan to pay secondary. It may be a hassle but it may be worth it!

Irishcurls

jezica125 said:

I have two health insurance companies. I have tricare because my husband is active duty. That's my primary health insurance. I also get health insurance from my job, and that's considered my secondary. For us- everything will be covered under our primary insurance provider luckily. Certain procedures and surgeries however are not covered by tricare. That's when the doctor/surgeon will bill tricare and when tricare kicks back a bill because they didn't cover it- the office then submits that to my secondary. It's quite a pain because we pay monthly for both insurances. And for both there is deductibles and co-pays etc. I am dropping my secondary insurance through my work immediately come Jan 1 which is the soonest I am able to.

I wonder how you got tricare as your primary! My employer's plan had to be primary I was told... I guess it doesn't really matter that much, but perscriptions would be cheaper if tricare was my primary. Do you have standard or prime? I'm not in a prime location so that may be why they disnt let me make Tricare primary...

I work for an insurance company as well. Fyi it doesn't matter if your policy is secondary. You can still submit your drugs to your plan to pay secondary. It may be a hassle but it may be worth it!

Yeah I think this is maybe what she means as primary? Because Tricare can't be your primary as far as I know. Great drug coverage though!!