doubling up on medical benefits?

March 3, 2005 2:41 PM

My wife works for the local school system and has excellent medical benefits through them. I'm starting a new job on Monday and will be allowed to enroll in their medical benefits program. Is there any reason to enroll at the job given how good my wife's medical insurance is?
posted by jperkins to Work & Money (9 answers total)

From someone who used to work in HR. It's always better to have coverage somewhere else. Unless it costs you money, think of it as just another safety net. In some cases, your second insurance plan can cover the deductibles your first makes you pay.

Additionally, if you'll probably only be able to join your new employers plan once a year (open enrollment period...) if you decide not to join now. I hate to say it, but something might happen in the next few months that would leave you and your wife without coverage until the next open enrollment period at your new job. Better to be safe than sorry.
posted by pwb503 at 2:45 PM on March 3, 2005

I don't think so. Some companies will even give you part of the money you're saving them by not enrolling in their health plan. As for unforseen circumstances, most companies let you enroll if you have a "life event".
posted by electroboy at 2:48 PM on March 3, 2005

I'd say compare costs. When we got married, I dropped my insurance at work like a hot rock. It was expensive. We're saving money (more than you might think) by having consolidated it all. And, electroboy is right, generally there is a life events clause. Just check to see what that means at your particular company.
posted by Medieval Maven at 2:57 PM on March 3, 2005

If there's no downside, keep both. Even if your wife's insurance is almost entirely better, there is likely to be some area where your own insurance has better coverage.

Do read all the details, however, and discuss it with your HR people.

For example, here in Canada, if both parents of a child have a benefit package that would cover that child, the child is covered by the plan of the parent whose birthday is earlier in the year (this is an agreement between the insurance companies). If the parent with the later birthday has the better benefit package, the other can opt out of covering for the kids -- costs nothing and takes two minutes, but if you don't know about this part of the terms you might get an unpleasant surprise. Anyway, that doesn't apply to you but it's just an example of the type of thing to look out for.
posted by winston at 3:14 PM on March 3, 2005

if you'll probably only be able to join your new employers plan once a year (open enrollment period...) if you decide not to join now. I hate to say it, but something might happen in the next few months that would leave you and your wife without coverage until the next open enrollment period at your new job. Better to be safe than sorry.

Most employers will allow you to change your coverage mid-year under certain qualified exceptions, under which this situation would almost certainly fall. So this shouldn't really be a concern. You should verify this with them, however.
posted by casu marzu at 3:19 PM on March 3, 2005

Having two medical policies can cause a lot of headaches. The employer's medical plan likely won't cover you if you're already covered somewhere else, or if they do, they'll want lots of paperwork to make sure things don't get paid twice. One of the compensations for the low pay of teachers is a good health plan. Unless there's a compelling reason to switch, just stay with your wife's.
posted by anapestic at 3:53 PM on March 3, 2005

Best answer: I used to work customer service at a health-insurance company, and this is what I'd tell people when I got this question:

First of all, compare the benefits; if hers are better, just keep hers and be happy.

If you do decide enroll at your employer, then your employer's plan becomes your primary carrier -- they will pay first for all your claims. Your wife's employer's plan becomes your seconday, and that's where the trouble can start. Get a copy of her plan booklet and look for a section titled "coordination of benefits" or something similar; that'll describe what they pay in secondary situations. If hers is a "carve-out" (sometimes called "non-duplication") plan they will pay very little, if anything, as your secondary. This won't affect what they pay on her claims (since they will always be primary for her), but it could seriously affect yours.

Also, if you have children and enroll them, you need to find out whose plan would be primary; many carriers go by the "birthday rule" -- if your birthday falls earlier in the year than hers, your plan is primary. If you can get better well-child or dental coverage through her plan, keep the kids off yours.
posted by ubernostrum at 4:03 PM on March 3, 2005

You may not want the basic medical coverage (ubernostrum has it right about primary coverage, as you've noted), but do look at dental, vision, disability, and life insurance options. They may be better at your new company. Also, you rarely need to take a physical or provide medical information when you get term life insurance via your employer, which is a GoodThing [tm] because you can get denied (or pay higher rates) for almost any (small thing) in your records. And often if a spouse can be included on a life insurance policy of the employer, it's only at some ratio (for example, the amount of life insurance the spouse can get is limited to a maximum of 50% of the insurance amount of the employee).
posted by WestCoaster at 8:27 PM on March 3, 2005

Both my wife and I work for school districts. In our case, we both have insurance as we can double up our benefits. For medical, we have no co-pay, no prescription and very small emergency room charges. For dental, we pay nothing (vs. the 30% co-pay we would normally have to pay). My wife was very sick for a year a little while back and after hundreds of thousands of dollars of treatment, we had paid nothing. Not one penny. At the very least, we would have paid prescription and co-pay charges which would have run over $1000.

All that being said, I would recommend (as others have) asking around at work a little more. I don't pretend that we work in "the real world" and haven't had to deal with benefits outside of school districts. My last question is this -- does it cost you anything to enroll at your job? Will you get money back if you don't? If not, then I don't see why you wouldn't enroll. Unless, of course, you can't use her insurance to make up the difference that yours won't provide.
posted by xorowo at 6:29 AM on March 4, 2005