How to make the most of too much insurance?
July 19, 2012 10:04 AM   Subscribe

My wife and I each have medical insurance through work under different providers that covers the other. What is the best way to take advantage of a ridiculous ammount of insurance until I can cancel mine in January?

Short story: Wife takes new job, gets new insurance. I try to cancel mine since I'm covered under hers, but since I'm outside the HR window at my job we're both still covered under mine also until January.

Both are PPOs, different providers.

Is there any way to take advantage of the extra money we're spending (wasting?) on medical insurance in the meantime?

Can I dontate insurance?

Max out medical massages?

posted by fredericsunday to Grab Bag (11 answers total)
I'm assuming that you are in the US. I don't know which state, but I know that in Minnesota a spouses new job counts as a "significant change in live event" and you should be able to make changes to your insurance even if you are out of the open enrollment window.

In addition, I know that my insurance company audits periodically and calls/emails to ask me if there is a chance that I am covered under any other policies. The idea here is to make sure that they detect any kind of double-dipping.
posted by sparklemotion at 10:08 AM on July 19, 2012

I don't really understand why you are paying for EE+Spouse coverage on two plans. You could either pay for EE Only coverage on both plans or just pay for EE+Spouse coverage on one plan right? Is her company's open enrollment at a different time of year?

I will say you can't donate medical insurance though.

Things that usually have limits that you could use on both plans are things like chiropractors, and mental health visits, possibly things like acupuncture.
posted by magnetsphere at 10:11 AM on July 19, 2012

If you want to use her insurance, try to drop your insurance now under the "change of life event" rules. Make sure there's not a waiting period before it kicks in, though.

While it theoretically sounds really good to have dual insurance coverage, what will actually happen is that for even basic medical care, each insurance company will try to claim the other one should be the primary payor and it will take forever and be a giant hassle to settle even the simplest claim.
posted by The Elusive Architeuthis at 10:19 AM on July 19, 2012

Response by poster: United States

Outside of "Change of Life" Rules time window for both programs. I neglected to cancel my insurance in time.
posted by fredericsunday at 10:21 AM on July 19, 2012

You are very possibly going to find yourselves involved a situation where neither insurer will pay for anything because they claim the other insurer is the primary.
posted by Thorzdad at 10:21 AM on July 19, 2012 [5 favorites]

As sparklemotion said, the new job should allow you to cancel your coverage outside of open enrollment. That is probably the best thing to do. Due to the way co-insurance works, having two major medical plans only gives you the best coverage of either one plus possible paperwork headaches that you would not have under a single plan.


Your coverage pays 80% and hers pays 90%. You are covered at 90%. Period. But, because you have coverage through your job, they are the primary insurance for you, thus your doctor has to submit a claim for 80% under your insurance and the other 10% under hers. If you cancel your policy, they can submit one claim for 90% under her insurance.

Only possible loophole: If one plan, say, covers chiropractic treatment but not accupuncture and the other covers accupuncture but not chiro, then you could have coverage for both of those. Given how cheap chiro is compared to an MD and how expensive major medical is, the odds are poor this would be worth keeping two plans for.

(I paid insurance claims for five years. How co-insurance works was covered in my initial training.)
posted by Michele in California at 10:23 AM on July 19, 2012

There's not much elective things you can do with health coverage that isn't so elective it's not covered.

-Get dietary advice from a nutritionist.
-Get PT for any muscle or orthopedic issues you've had in the past. (Or chiropractics, if that's your preference)
-any non-otc birth-control measures
-smoking cessation
-check your formulary and stock up on any prescription meds you keep around that're cheaper on the expiring plan compared to the new one.

Does this extend to dental coverage? If so, extract any remaining wisdom teeth.
[Cadillac] Orthodontic coverage? Get braces again!
posted by Sunburnt at 11:03 AM on July 19, 2012 [1 favorite]

She doesn't cover you under her insurance. You don't cover her under yours.

Once your wife gets her own coverage, you can cancel her off of your insurance, usually before the next pay period.

When she gets hers, she doesn't add you as a dependent.

Husbunny and I each have different plans covered by our respective employers.
posted by Ruthless Bunny at 11:20 AM on July 19, 2012

Where I live, double-coverage like yours means we don't pay co-pays. This means fully covered individual therapy, family therapy, physical therapy, and fertility treatments, among other things. So, this is a good time to get a fertility workup, or get unsightly, possibly cancerous, moles removed, or get your emotional issues addressed, or finally deal with that repetitive stress injury.

You'll want to talk to your insurance companies about "coordination of benefits" so that the correct insurance is listed as primary. Then at each office visit or whatever, present both cards and specifiy which one is primary as well. I've got a small P sharpie'd on my card to help me remember.
posted by mmmcmmm at 1:24 PM on July 19, 2012

make sure that when you're off your insurance in the new year, you're not paying too much to be covered via your wife. A couple of years ago I turned down coverage at my job and took coverage through my spouse's policy, and we were charged a pretty good monthly fee in addition to the regular because I *could've* been covered w/my employer but chose not to be.
posted by hms71 at 12:14 AM on July 20, 2012

It really depends on the terms of both plans, but usually in this situation the two plans will coordinate benefits, so that the secondary plan (usually the plan where you are a dependent/spouse pays secondary) doesn't pay anything until the primary plan pays, pays only what that plan didn't cover (e.g. might not "double up" in the sense you are saying).
posted by Pax at 6:20 AM on July 24, 2012

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