USA medical primary and secondary insurance quandary

December 16, 2021 10:52 AM

My medical insurance from OldJob ends on 12/31/2021. The insurance covered my family (spouse, son, and me). The NewJob insurance starts 1/1/2022 and is not as good and much more expensive. However, spouse’s insurance at SpouseJob is about as good and affordable as my OldJob insurance, and the whole family can be covered. But SpouseJob requires that if I am to be covered with their insurance, I must also purchase NewJob insurance for myself as my primary insurance and SpouseJob insurance as my secondary insurance. Is it worthwhile and cost-effective to have primary and secondary medical insurance?

Spouse and son will definitely be on SpouseJob insurance. It will cost $105 a month extra to include me on the same insurance.

This is in Washington State. SpouseJob insurance is with Premera/Blue Cross, and NewJob insurance is United Healthcare. Premera is much better to work with than United Healthcare - my spouse is a nurse and has to talk to insurance companies on behalf of patients frequently, and the experience with United Healthcare is not positive.

For those that have had primary and secondary insurance, is it worthwhile? It does seem it could be somewhat of a hassle to have to manage the same claims made to two insurance companies. I typically have four or five medical claims for myself to make a month.

My NewJob insurance had three tiers of coverage for employee only (monthly cost/deductible): $230/$3500, $285/$2000, $316/$1000

One plus is that both NewJob and SpouseJob have their open enrollment periods in June, so in six months I can change how I do things. However, the six months means I have only half the time to meet the deductibles by the time they reset for the new enrollment period.

posted by Sock, Sock, Sock, Sock, Sock, Goose! to Work & Money (3 answers total)

Best answer: Like everything with the garbage fire that is American Healthcare, having two health insurance companies is a nightmare. You will probably end up in a situation at some point where both insurance companies will insist that it is the other companies problem, and you will have to spend hours on the phone with both. Somehow faxes will end up being involved.

The basic question is whether the nightmare of having two health insurance policies is better than the nightmare of having one potentially crappy insurance policy, especially since you use a decent amount of healthcare services. You may not be able to answer this until you are already committed to one option or the other.
posted by rockindata at 11:22 AM on December 16, 2021

Best answer: Mr. DrGail and I have had primary and secondary insurance for some years now. Our primary is Medicare and the secondary is an Aetna PPO through the Federal Employee Health Benefits. For us, it's lovely since whatever Medicare doesn't pay (i.e., deductibles and copays) the secondary insurance does and we end up with no out-of-pocket costs.

But what really matters is how the two insurance plans coordinate. There should be some information in their brochures about how they coordinate with other insurance plans when they're primary or secondary. Even though it's a hassle, it's worth working through the insurance-ese to know what's in store for you so you can decide if it makes sense for your family.
posted by DrGail at 12:30 PM on December 16, 2021

Best answer: If I were in your shoes, I'd take that $105 that you would spend on secondary insurance and go with the Gold tier of your new job's insurance (since you use it a lot). See how your experience is, and if it's worth the costs. Give it the 6 months to try it out. And if you're not super happy with it, you can add the secondary insurance in June (possibly reducing to a lower tier at newjob to offset the cost). I don't believe the secondary insurance is going to be much help as you'll have to meet deductibles on both insurances, and secondary insurance is only going to pick up the cost on big stuff that primary insurance doesn't cover (which won't be much unless you have a major catastrophe).
posted by hydra77 at 4:11 PM on December 16, 2021 [4 favorites]