You’ve likely heard the saying “two are better than one.” Two shoes complete an outfit and protect your feet. Two gloves keep both hands warm during the cold winter. And, it’d be pretty difficult to ice skate on just one skate.
But, what about two health insurance plans? Does having a pair of heath insurance plans help protect you from out-of-pocket costs — above and beyond having just one? The answer is: it depends.
What is double (or dual) coverage?
Double coverage happens when you’re enrolled in two different health insurance policies at one time. A variety of situations can lead to you having dual coverage. For example, you may have a plan through your employer and your spouse’s employer. Or, maybe you’re under age 26 and still on your parents’ policy but also have a plan through your employer. In each situation, you’ll have to pay a monthly premium for both plans, plus meet any deductibles that may apply before benefits kick in.
When you have double coverage and file a claim, the payment for that claim goes through a process called coordination of benefits (COB). COB is when two plans work together to pay the claim for one person. It helps make sure the claim is paid accurately and determines which plan pays first and which pays second. If you have health insurance through your employer, your employer’s coverage typically pays first. In divorce situations, the court decree often outlines which parent has the primary responsibility for providing health care coverage to the child. If it doesn't, there are some general rules based on which parent has custody of the child.
The COB process also happens in claims involving both health and car insurance, and when another insurance company is responsible for paying for your care — like if you were to get hurt in a car accident and it’s not your fault.
Questions to ask when considering double coverage
If you have access to dual coverage, it’s important to ask questions to make sure you’re getting the most for your money. Just because you can enroll in two health insurance plans doesn’t always mean you’ll save on out-of-pocket costs.
What are the benefits for each plan?
Every health insurance plan is different and one plan may cover something that another doesn’t. It’s important to understand the benefits of each plan before you enroll. You can do this by reviewing your coverage manual or talking to your employer.
What are the out-of-pocket costs associated with each plan?
Having double coverage means you pay two monthly premiums and you may have to meet two deductibles before your benefits apply. Depending on how the two plans coordinate, the secondary plan could pick up your out-of-pocket costs leftover after your primary plan pays. However, it’s also possible that your secondary coverage may not pay anything.
Take a look at your monthly premium and out-of-pocket costs, and compare those to the costs associated with services you think you might need in the coming year to determine whether or not you'll save by having two plans.
What are the coordination of benefits rules for your plan?
Typically, if you have a plan through your employer, that will be the primary payer for you. But, how the plans coordinate may differ once a plan determines they will pay second. The method a secondary health insurance plan uses to coordinate payment may not result in the payment of leftover out-of-pocket costs after the primary plan has already paid. That’s why it’s important to know both plans' specific rules before choosing to enroll.
Get started with the help of myWellmark®
When deciding if having two health insurance plans is right for you, it’s helpful to consider health care costs for the future. You can also look back to see what you've spent on health care in the past. For Wellmark Blue Cross and Blue Shield members, it’s easy with the help of myWellmark. myWellmark puts your personal health care information at your fingertips, giving you a clear look into your health care usage and benefits. Log in or register for myWellmark Opens New Window today!