Health Insurance - times two!

October 28, 2004 10:24 AM

Double Insurance Coverage: I am now in an interesting situation -- I am covered under my employer's health plan (Regence/Blue Cross Utah), and an individual plan I bought earlier. What kind of rules might exist about how coverage from each applies? [more inside]

The new Blue plan has better first dollar coverage -- doctors visits are mostly covered, drug coverage is better. Also, it costs me something like $40/month. The individual plan, on the other hand, has some superior last-dollar coverage (compare lifetime limits of 2 million to 10 million) and is something I can take with me when I leave. Since leaving may happen soon, ditching the individual plan seems like a poor idea, but using the new Blue plan to cover a few doctor/dental visits that I've been thinking about for a while seems like a really good idea.

Except -- the new Blue knows that I have other insurance and sent me a letter asking for the information and telling me that it's not that simple. Anyone have any experience with this? Ideas about where to go to find out what's what? I do have the # for my state insurance regulators, and plan to call them... will they be any help? What should I ask?

posted by weston to Work & Money (6 answers total)

All health insurance plans I've ever seen are automatically void if you have other health insurance. So, you will likely be forced to ditch one or the other. What you should ask is "How can I get my money back?" if you've already paid premiums to both.
posted by kindall at 11:59 AM on October 28, 2004

All health insurance plans I've ever seen are automatically void if you have other health insurance.

That's not always true. You can have two separate insurance plans, however as stated by weston, you need to tell the insurance companies involved. There are a series of complicated rules which then come into play if you need to claim benefits due to hospitalization.

Doesn't your company have an HR person? Usually they can help. Also, I have Blue Cross and in my experience you should just call the member services number on your card and ask them.
posted by jeremias at 12:26 PM on October 28, 2004

That's odd. I have Kaiser Permanente in Southern Cal, and I also had HealthNet at the same time. Every time I went to Kaiser, they asked if I had any other insurance, I showed them the HealthNet card in addition to the Kaiser card, and HealthNet picked up the co-pay. I thought that was pretty nifty. I no longer have the HealthNet coverage though, now I'm just double covered by two seperate Kaiser policies (which again means no copay).

But like jeremias said, try calling and asking.
posted by DoomGerbil at 3:02 PM on October 28, 2004

Response by poster: Thanks for the advice, all. I've been a little reluctant to discuss it with our HR person because I thought they might think it was a little odd I was keeping two and I'm trying to keep it under wraps that I'm considering departing soon... and my experience with contacting insurance companies directly in the past (with some exception for my individual plan) is that they are weasels and it's good to go armed with information. But I think I'll go ahead and give the new Blue a call.
posted by weston at 4:26 PM on October 28, 2004

Being covered by multiple plans isn't necessarily going to set off alarms with the HR rep. It happens regularly with working married couples, after all. If you feel like you need to explain the individual plan away, though, just point out that you like the security of the higher lifetime limit.
posted by nakedcodemonkey at 8:45 PM on October 28, 2004

What you need to do first is sit down with the plan documentation you have for both plans, and look for the phrase "coordination of benefits"

Here's what Regence UT says about it from a physician's perspective:

http://www.ut.regence.com/physician/billing/
posted by antimony at 9:24 PM on October 28, 2004