Double the benefit, double the fun

September 16, 2011 9:03 AM

I can insure my spouse through my employer. My spouse can insure me through his employer. Right now we are just going with the better of the two plans. Is there any reason we would want to sign up for both?

We live and work in the USA. Both employer-provided insurance benefits are pretty comprehensive, as these things go. We are mid-30s, have no major health issues beyond a CPAP to feed and care for, which our current plan covers some of. No kids, none planned in the next year. We are financially secure as long as we stick to our (tight) budget, and have reasonably good family resources to fall back on in the event of a catastrophic emergency.

I was just wondering if it made any sense for us to "double up" on insurance or not. I can't imagine why it would, but our annual benefits enrollment period is approaching, so I wanted to see if maybe there's a part of the picture I'm not seeing.

Also...if we do start considering to bring kids into the picture, how does the insurance equation change? Would we want to consider doubling up then even if we don't now?

posted by thinkingwoman to Work & Money (18 answers total)

Back about 20 years ago, my wife and I double covered each other, and it turned out to be a good thing, as she got an extra day in the hospital after our daughter was born because of it (like her plan covered her first, then mine kicked in and it had the option for an extra day).

However, they (whoever "they" are) passed a rule that you could no longer have that kind of double coverage, for medical at least (we still do it with dental). Not sure why, or if it's a local or statewide rule, or what. You might want to check with your HR dept and find out if it's even an option for you or not.

For the kids, we just looked at the costs and ended up insuring them under my employer, as ikt was a better deal for adding dependents.
posted by jasper411 at 9:13 AM on September 16, 2011

Don't do this. It makes much more paperwork for care providers, and the insurers each will do everything they can to defer claims to the other.
posted by seanmpuckett at 9:14 AM on September 16, 2011

Your question is specific to health, but I'll toss in for life insurance, should you roll that way. Buy an insurance policy outside of either of your employers.

I carry life insurance through work, great rates etc. But I've been laid off a few times, and the premiums to continue (post-layoff) are worse than a standard life policy. And the older you are, the higher premiums are for standard policies, so the longer you wait, the more you'd pay.. So pick up a life insurance policy outside of what work offers. (I still carry what work offers, it's like $5 a pay period, dirt cheap, but ..)

(note I'm talking standard 20 year term stuff, the cheap-o insurance, no convertible bells whistles cash value blah blah stuff..)
posted by k5.user at 9:19 AM on September 16, 2011

Best answer: Don't do this. It makes much more paperwork for care providers, and the insurers each will do everything they can to defer claims to the other.

Oh, hell yeah. You're setting yourself up for an epic battle between your providers that will end up delaying everything you try to do. There's enough of a problem getting anyone to pay as it is, don't compound that with issues around which company is responsible.
posted by tommasz at 9:22 AM on September 16, 2011

We did this for optical insurance and it was AWESOME. You can get new frames every year or contacts and frames (or sunglasses and frames etc.)
posted by Kimberly at 9:27 AM on September 16, 2011 [1 favorite]

Best answer: This isn't exactly your question, but I'd think that it would be most cost effective for each of you to just be insured by your own employer. Employers usually pay a lot more of the premium for employees than they do for spouses. Just another option to look at.
posted by crunchtopmuffin at 9:31 AM on September 16, 2011 [4 favorites]

We double-insured my wife during her pregnancy and delivery earlier this year. I don't recall the exact figures, but it saved us several thousand dollars.
posted by Uncle Jimmy at 9:33 AM on September 16, 2011 [1 favorite]

It would depend specifically on what type of insurance plans they are (HMO, PPO, etc...). In some cases it might make sense if you know ahead of time that the secondary insurance provider would pick up what the primary ins provider didn't pay. As a rule though, it's not worth the effort of the added expense on your parts.
posted by Hanuman1960 at 9:45 AM on September 16, 2011

Not only does it depend on what kind of insurance it is, it also depends on what the plan itself says. Sometimes you can have a "primary" insurance and a "secondary" insurance. Sometimes, though, companies or plans have policies were you can't. What you might want to do is ask one or both of your companies if they would be willing to give you a stipened for electing not to be insured (at my company, if I had other insurance coverage, I would get $100 per paycheck). They might not do it now but might consider it if someone asked.
posted by dpx.mfx at 10:06 AM on September 16, 2011

For things like pregnancy and catastrophe, double insurance can be very good. For every day things? I did this for about 6 months, because I had my own BCBS health policy before I got an office job. Then the office job covered me.

Every office visit, both insurance companies argued with me about which was primary. I listed the BCBS as primary, because I had it first, I paid it out of pocket, and I liked the coverage better. The work insurance covered whatever BCBS didn't cover. Well, BCBS wanted to be secondary and pay less. And the work insurance loved the idea of being secondary.

It was a huge headache, but I got it sorted out in some satisfactory way, which I can't remember. It didn't last long because I was only at that job for 9 months. until I decided that throwing myself over a railing and getting hospitalized would be better than dealing with the mean soul sucking bitchy manager for another ten minutes. So I got in my car and went home, in tears. It was the first time I ever walked out on a job, and looking back I can't even remember if I had canceled the original health insurance or not. But that visceral rationalization of hurting myself, and my immediate steps to avoid that are very vivid.
posted by bilabial at 10:11 AM on September 16, 2011 [1 favorite]

In Pennsylvania, at least, the primary insurer of the kids depends on the "birthday rule". I think this meant that my husband's insurance (he was born in July) was primary for the kids, even though I had better insurance when we were double-covered for medical (my birthday is after July). We could not choose which coverage we wanted to use first. I could not believe such an important decision was made so . . . capriciously, but it was. Second insurer was used as coordinated coverage, but if one insurance is an HMO, and one's Blue Cross, unpleasant surprises may occur. I'd recommend calling the insurers in question, or at least HR of the respective employers for specific guidance.
posted by citygirl at 10:31 AM on September 16, 2011

I'm in Canada, so YMMV, but when my wife was working full-time she had slightly different benefits than me, so we both paid for dental/vision insurance. Because of it we got basically 100% coverage on everything. She's only part time now, so we lost those benefits. They were worth paying extra for.
posted by blue_beetle at 11:28 AM on September 16, 2011

I was just wondering if it made any sense for us to "double up" on insurance or not.

You can't actually do this. Insurers have what are called "coordination of benefits" clauses in their contracts which prevent insureds from getting double benefits. As others have mentioned, this is likely to cause a headache down the road, as the carriers fight over which of them is primary. I guarantee you, they're looking for an excuse to be anything other than primary, so simply eliminating this as an issue can be worth doing.

More than that though, many employers actually impose a penalty fee to enroll spouses that have access to health coverage through their own employer. This is on top of the extra they normally charge to add a spouse in the first place. You'll need to consult with both of your HR departments to see whether or not this is the case.

Of course, because health benefits vary so widely, it may actually be cheaper to just go with one of them even with a fee. You'll have to do your own numbers.
posted by valkyryn at 11:28 AM on September 16, 2011

You're in the US, right?
Me too. My family has double coverage.
Your insurance is your primary coverage; your husband's is your secondary coverage.
His insurance is his primary coverage; yours is secondary for him.
These rules are dead simple clear.

For most of our working lives, we have had double covrage on the same insurance plan. This was fantastic, as it completely eliminated any deductibles or co-payments. Even for prescription medications. I felt like a queen in the pharmacy.

Last year we had to split to two plans in order to cover a child at a college where our main insurance plan does not provide care. It is more complicated with two plans; I hate having copayments. We at home use our main plan. College kid uses the new one while at school, and the old one when at home. I believe the old one is now secondary for her, but the coordination of benefits is something insurance companies are used to. They have a whole department for it. So it is working fine for us.
posted by SLC Mom at 1:10 PM on September 16, 2011 [2 favorites]

Also, we it gives us a wider range of options in physician and hospital choice, should we ever want second opinions and such.
posted by SLC Mom at 1:11 PM on September 16, 2011

Check out what your state mandates. Where I live, having double coverage means that the secondary insurance covers my co-pay on *everything*. What I save on prescriptions and co-pays on regularly occurring medical expenses each month exceeds what I pay for my insurance. When we ran into an unnamed very expensive medical expense a while back, by having double coverage, we saved the equivalent of my annual salary. No joke.

The paperwork is really no big deal. Billing departments are used to working with double coverage (at least they are where I live). The only hassle I've had is that a specialty pharmacy only had the computer ability to input one insurance company (although they had no problem with the actual secondary coverage, it was just a glitchy computer thing), so I had to submit a paper claim for that particular co-pay. I got a reimbursal check about a month later.

But if you don't need it and would hardly use it, then don't bother. It's just a cost-analysis thing. Does the benefit you get by double coverage exceed the price you pay for the coverage? And a risk analysis thing too: do you feel comfortable that you won't run into a very expensive medical expense in the next year that would make the benefit of the double coverage worth it?
posted by mmmcmmm at 1:32 PM on September 16, 2011

Your insurance is your primary coverage; your husband's is your secondary coverage.
His insurance is his primary coverage; yours is secondary for him.
These rules are dead simple clear.

The same is true for my household.
posted by mmmcmmm at 1:41 PM on September 16, 2011

We have dine this for years and it's absolutely worth it for us. We thought of ourselves as pretty healthy people-then my husband's psoriasis got worse, needed expensive meds, then he was diagnosed with Crohn's. His medication, about $2K a month, costs us nothing, as my insurance picks up what his doesn't. Zero hassle for us. We have children, also generally healthy-until our toddler ended up in the hospital for 11 days this March. Bill for hospitalization alone was 46K. We paid zero.

We've never had any significant trouble re benefits coordination.
posted by purenitrous at 10:00 PM on September 16, 2011 [1 favorite]