With health expenses going up, many people are asking if it’s possible to have two health insurances and how to make the best use of both plans.
Yes, it is possible for someone to have secondary health insurance and perfectly legal, but it is also important to fully understand how primary vs secondary insurance operates. Even though it may sound like more work having twoindividual or family health insurance plans, having a second health insurance plan can help you cover some of your insurance expenses.
On the other hand, you might also be responsible for two monthly premiums and two deductibles. Therefore, as you consider getting a second long orshort-term health insuranceplan, you need to think carefully about what would suit your situation the best.Learn more about health insurance, and decide if having a second health insurance plan is best for your needs.
Understanding dual health insurance coverage
Having two health insurance plans does not necessarily mean that you will be fully covered two times. For example, if you go to the doctor’s office twice, this doesn’t mean you are going to get reimbursed twice. Or, if you go to pick up your prescription medication, it doesn’t necessarily mean that you are going to get reimbursed twice for that medication.
Dual health insurance coverage, or having more than one health insurance plan, can be a bit confusing. It can lead to questions about coordination of benefits (COB), a crucial factor when you have multiple health insurance policies. In the following sections, we’ll explore dual health insurance coverage in more detail and delve into how COB works.
Coordination of Benefits (COB): How it works
Typically, there is aCoordination of Benefitsprovision that informs your health insurance plans. What this means is that there is an order to which your health insurance policies payout. Insurance companies do not want to incentivize someone to have multiple insurance plans only to get reimbursed multiple times for the same visit. The Coordination of Benefits will specify which plan pays first, reduce the duplication of benefits, and increase the efficiency with which claims are processed.
Understanding primary and secondary insurance
- Primary insurance:the insurance that pays first is your “primary” insurance, and this plan will pay up to coverage limits. You may owe cost sharing.
- Secondary insurance:once your primary insurance has paid its share, the remaining bill goes to your “secondary” insurance, if you have more than one health plan. Your secondary insurance may cover part or all of the remaining cost.
Note that both the primary and secondary insurance will cover up to plan limits. After the secondary insurance has paid its share, you may be responsible for any remaining amount that wasn’t covered. So, even if you have multiple health insurance policies, you may still have leftoverout-of-pocket medical costs.
If you’re concerned about your out-of-pocket costs, taking the time to shop and compare health plans may help. eHealth’s plan finder tool makes it easy to compare plan costs like premiums, deductibles, and copayments side by side.
How do I know which insurance will pay first?
When it comes to primary versus secondary insurance, the question of who pays first depends on the situation.
For example, if you’re a child with two parents who both cover you under their respective family plans, your primary insurance is decided by something called “the birthday rule”. The primary coverage will come from the parent whose birthday comes first in the calendar year. Note that it’s not a matter of which parent is older, but whoever has the earliest birthday.
Whenever you make a health insurance claim, your primary insurance plan will act as if you had no secondary plan and provide you with your benefits. Then your secondary insurance plan kicks in and covers the rest of the cost if it’s covered and necessary.
| Situation | Primary | Secondary |
| You’re under 26 and covered by your school/employer’s plan and your parents’ health plan. | school or employer-sponsored coverage | Parents’ coverage |
| You’re married and both of you have coverage through your employers. | Your employer’s coverage | Your spouse’s employer coverage |
| You’re under 26 with married parents, and both parents cover you under their separate policies. | The parent whose birthday is first in a calendar year (“birthday rule”) | The parent whose birthday comes second in a calendar year |
| You’re under 26 with married parents, and both parents cover you under their separate policies. | The parent with custody of the child. If both parents have joint custody, the birthday rule applies. | The parent who doesn’t have custody (if applicable) |
| You’re under 26, married and covered by both your spouse’s plan and your parents’ plan. | Spouse’s coverage | Parents’ coverage |
| You have a health plan and also receive Medicaid. | Your health plan | Medicaid coverage |
Pros and cons of having multiple health insurance policies
Advantages of dual health insurance
Is it a good idea for you to have multiple health insurance plans? There are several significant benefits you may enjoy if you have two separate health insurance plans. They include:
- Lower extra costs: If you find that you frequently have to pay medical expenses out-of-pocket because your current health insurance plan does not have enough coverage, then having a second health insurance plan can be beneficial.
- Reduce coverage gaps: If one of your health insurance policies lapses, then you will not have a gap in your coverage. Your second health insurance plan will automatically be there. You don’t have to worry about going without coverage.
- Potential for more coverage and benefits: You may get access to more coverage and greater benefits if your two plans are complementary. What this means is that you need the plans to cover different aspects of your care. That way, you fill gaps left by your first health insurance plan.
Clearly, there are a lot of benefits that come with having two health insurance plans, but you have to find the right plans to complement each other.
Drawbacks of dual health insurance
Even though there are a lot of benefits that come with having two health insurance plans, there are a handful of drawbacks as well. Some of the biggest drawbacks of having two health insurance plans include:
- Out-of-pocket costs: Having two health insurance plans, doesn’t necessarily mean that you will be completely covered regarding your out-of-pocket expenses. Remember that the combined coverage of your plans cannot exceed 100 percent of your out-of-pocket costs. If you want to get paid for going to the doctor, that will not happen even if you have multiple policies.
- Double premium & deductible payments: You will still be responsible for two premiums and two deductibles. That means that you could end up incurring additional expenses.
- Navigating additional policies: You will need to navigate to separate policies and rules. Furthermore, the reimbursem*nt process may take longer or have more mistakes because your health insurance providers have to navigate multiple benefits.
- Potential coverage overlap: They might be too similar andcould overlap with their coverage, meaning that you do not get a lot of additional benefits.
- Complications with billing: When you go to the doctor’s office, the doctor may only want to bill a single policy. They may not want to bill the other policy. This means that the process could become more complicated, and your doctor might get frustrated.
For all of these reasons, you need to think carefully before you decide to get a second insurance policy. It is not necessarily the best move for your health coverage, but there are some situations where it can be helpful.
When it makes sense to have two health insurances
While having two health insurance policies might initially seem like an added complication, there are situations where it makes sense and can be beneficial. In this section, we’ll discuss scenarios where you might consider having dual health insurance coverage and how it can work to your advantage.
Scenarios where dual health insurance may be beneficial
Reasons someone might have two health insurance plans include situations such as:
- You are a married couple, and both of you have health insurance through your own employers
- You are under 26 years old with divorced parents, and both parents list you as a dependent under their separate plans
- You’re under 26, married and covered by your spouse’s plan and your parents’ plan
Challenges and pitfalls of dual health coverage
When you’re covered by two health insurance plans, it can introduce complexities and potential challenges. While dual coverage can provide additional financial protection, it’s essential to be aware of the potential pitfalls and difficulties that may arise when navigating multiple policies. In this section, we’ll explore some of the common challenges and pitfalls associated with having two health insurance plans and provide guidance on how to navigate them.
Common mistakes to avoid with multiple health insurance plans
Having multiple health insurance plans can be advantageous, but it can also lead to common mistakes if you’re not careful. Here are a couple of typical errors to avoid:
- Double Billing: Sometimes, healthcare providers may mistakenly bill both of your insurance plans for the same service. This can lead to overbilling and confusion. Make sure to review the explanation of benefits (EOB) from each plan and contact your providers to clarify any discrepancies.
- Assuming Dual Coverage Is Always Better: While dual coverage can be beneficial, it’s not always the best option for every situation. Don’t assume that having two plans will automatically save you money. Evaluate the costs, coverage, and your specific healthcare needs to determine if dual coverage is cost-effective.
These common mistakes can be easily managed with a proactive approach to understanding your coverage and effectively communicating with both insurance providers.
How to apply for and manage multiple health insurance plans
Applying for and managing multiple health insurance plans can seem daunting, but with the right approach, it can be a beneficial strategy for comprehensive coverage. In this section, we’ll provide guidance on how to navigate the process effectively. Whether you’re coordinating dual coverage through your employer and a spouse’s plan or exploring other combinations, understanding the steps involved and staying organized is crucial for success.
Comparing multiple health insurance policies
One of the best ways to lower your overall health-care expenses is to compare plan costs and benefits with a licensed insurance broker like eHealth. Since health insurance costs are regulated by law, you’ll get the same price no matter where you buy. So, the best strategy is to shop at a broker like eHealth that offers a large selection of affordable health plans in one place.
Key factors to consider when managing multiple insurance plans
If you think you could save money with multiple health insurance plans, think about your current and future medical needs. Then, estimate if the cost of paying two plans’ premiums, deductibles, and more would outweigh the extra coverage of two plans.
Expert advice on choosing multiple health insurances
If you’re considering the complexities of managing multiple health insurance plans or want guidance on the best strategies, eHealth is here to help. Our licensed insurance agents are ready to provide expert advice and answer your questions. To get personalized assistance, you can call us at 1-844-994-1194. If you prefer a more direct approach, use our live chat feature on the eHealth website to chat with an agent. We’re dedicated to helping you make informed decisions about your health coverage, ensuring you get the most out of your insurance plans. Don’t hesitate to reach out – we’re here to assist you every step of the way.
FAQs about having multiple health insurance policies
Does having two health insurance plans lower out-of-pocket costs?
There are some situations where having two health insurance plans can help you reduce your out-of-pocket expenses. For example, if you have two health insurance plans that cover different areas of your medical needs, then one policy may cover one area while another policy covers the other area. That way, you may reduce your out-of-pocket expenses.
Are there different types of secondary insurance?
Yes, there are different types of secondary insurance coverage. You may want to find a plan that targets the area of your coverage that you require the most. Vision, dental, disability, life insurance, accident insurance, hospital care, and Medicare supplement insurance are just some of the areas that secondary insurance can focus on helping you with in addition to your primary insurance. For example, if your primary plan does not cover a lot of your hospital costs and you think you will be needing hospital care in the future for a major surgery or for an extended period, a secondary hospital care insurance may be right for you. This type of plan may cover you for unexpected illnesses such as a heart attack with a cash payment.
Does the secondary insurance cover copay?
There are some situations where your secondary insurance policy could cover yourcopay. There are some insurance plans that require you to pay a copay when you go to the doctor, but there are other insurance policies that may not require a copay. Therefore, if you decide to use the insurance policy that does not require a copay, you might not have to pay a copay for certain hospital visits.
What is the billing process when you have two health insurances?
If you have a primary and secondary health insurance, your bill will not be given to both of them at the same time. Your primary insurance will typically be billed first unless there is a rule under your Coordination of Benefits provision that decides which insurance pays first. Once your primary insurance has done its part, you can then send the bill on to your secondary insurance. Keep in mind that you should always send the full bill to your secondary insurance provider as they will want to see what your primary insurance has already paid and why your bill was not fully paid by them. Sending a total bill can avoid your secondary claim from being rejected.
