Health insurance overlap! Two health insurance companies - is this ok?

Question

Is it legal to have medical insurance with two separate health insurance companies during the transition between the two?

And if one denies a claim, can you still file with the other?

Answer 1

Yes, it is legal, and some people have dual insurance all the time (married couples who both have insurance paid for by their employer where one has single coverage and the other has family coverage, which covers the kids AND the other spouse - the "other spouse" will have dual coverage).

The way it works is that the claim will be filed with your primary insurance (and that will be the plan you have had the longest since both plans are held in your name, not one in a spouse's name OR, if one is in your name and one in your spouses, then the one in your name is considered primary. It gets even trickier when you have kids that have dual coverage, but I won't go into that since it doesn't apply in your case). Whatever they do not pay will then be filed on the 2nd insurance.

Whether or not the 2nd insurance will pay a claim that the 1st insurance has denied will be based on whatever the policy is with that 2nd plan. For instance, you go to the chiropractor, which isn't covered by insurance 1, but is covered by insurance 2, then it will be paid at the regular rate that insurance 2 pays for it.

If you file a claim for say cosmetic surgery, which insurance 1 says is not a covered expense and they deny it, then it is filed with insurance 2. It may also not be a covered expense under insurance 2's policy. In that case, it won't be covered.

If insurance 1 pays part of a claim, then the balance is filed with insurance 2. In most of these cases, you are only responsible for a very small co-pay and possibly not anything at all.

Answer 2

Insurance Overlap

Answer 3

It's legal, but it can be a headache. You might run into the Coordination of Benefits issue - it's where one plan finds out about the other and the two plans end up pointing fingers at one another saying "That one is primary". SO, to avoid that headache, you have to designate one plan as primary. (If they're held by two separate people - like a husband and wife - it's easy. You go by what's called the Birthday Rule - whomever's birthday falls first in the year, regardless of who is older, holds the primary plan.) If the same person holds both plans, use one until it runs out, then go to the other.

Answer 4

Get insurance quotes

Answer 5

Yes its legal... and, yes you should file to both...

However, you should only file to your secondary once your primary has paid. You shouldn't file to both, without the insurance companies knowing about the other company... Make sense?

Answer 6

Both of the above answers are great but you also have to factor in that your employer drives which is the primary insurer for you. So your benefits through your employer will be primary and your spouses employers benefits will be primary for him.

Good luck!

Answer 7

I had asked the same question 2 times, and haven't got a proper answer

Answer 8

Yes, it's possible