Can you have two health insurance companies & plans?
January 19, 2015 2:30 PM   Subscribe

Hi MeFi, So a bit of a weird situation here. I was laid off in 2013 and at the end of that year I applied for Obamacare. It took FOREVER to get the application going since the website was awful so long story short, it's early 2014 and I get a job with full benefits. I completely forget about the application for Obamacare and it's now January 2015 and I received a letter from CeltiCare Health saying 'hi, here's your coverage card. you are now insured with celticare...' So now, technically, I have two coverages? One from my employer and through Celticare? How does this work? Should I call Celticare and let them know I already have insurance? What benefits are there to having two? Legal or not? Thanks for your help!
posted by bostonhill to Law & Government (12 answers total)
 
Yes, call Celticare and tell them you're currently insured with your new job.

If your status has changed since you applied, it won't be cheap, or free anymore, so no, there's no benefit to having both.

In some cases you can have two providers, one primary and one secondary, but it gets weird and is rarely worth it.
posted by Ruthless Bunny at 2:34 PM on January 19, 2015 [1 favorite]


Have you made a payment to CeltiCare? If not, you probably don't "officially" have coverage.
Anyway, since, by the law, if you have accepted your employer's coverage, CeltiCare would no longer apply. Call CeltiCare and cancel their coverage as of Jan. 1. You may have to provide proof of coverage on your employer's plan. Make sure that document shows you covered as of Jan. 1.

This actually happened to my son this year. He called to cancel his Obamacare policy in December, since he had to take his employer's plan. Somehow, the cancellation never made it into the system, resulting in a lot of phone calls, faxes and finger-crossing.
posted by Thorzdad at 2:38 PM on January 19, 2015 [1 favorite]


I have not made any payments to Celticare. Much to my surprise was when I received the coverage ID card and a new primary doctor.
posted by bostonhill at 2:43 PM on January 19, 2015


In some cases you can have two providers, one primary and one secondary, but it gets weird and is rarely worth it.

Oh my god, yes. This. This is really the best way to describe what you're looking at; I worked at a grocery store that provided benefits for its employees, even the part timers…even the folks who worked like, a day a week. I switched jobs, but kept working like two evening shifts a week there for a couple months (uhg, its a long story, and not at all worth telling).

Anyways. For like three months I had two health insurances. It was stupid. Every visit was at least a half dozen phone calls to get everyone to cover what they were supposed to, I didn't really end up saving money on health-care.

If you don't like waiting on hold a bunch, or filling out buckets of paperwork, I'd just drop the other one. Not to mention that it'll probably be notably more expensive than the stuff provided through your work
posted by furnace.heart at 2:43 PM on January 19, 2015 [1 favorite]


I've never HAD two health insurance plans, but lived through a transition during a company merger where one plan left off and the new plan took over. No break in coverage, no overlap in coverage. And STILL every claim that healthcare providers made on my behalf got backed up by the incoming company trying to claim that I had other coverage which should pay for it. Thank God I didn't have a major medical problem during this time. Get one or the other cancelled quick.
posted by randomkeystrike at 2:46 PM on January 19, 2015 [2 favorites]


There's nothing illegal about having two insurance plans but generally is it not worth the extra expense. Generally the employer plan will be primary and pay everything up to its defined limits. The secondary plan will then pay the difference up to the full medical cost, but is still subject to the same deductibles. You cannot get back more than 100% of medical cost.

If you are satisfied with your employer plan, simply cancel the Obamacare plan. All health plans are paid month-by-month in advance. If you don't pay your monthly premium, your insurance is simply cancelled. You aren't on the hook for a full year of premiums.

Apparently Celticare assumed, even though you had not submitted your first payment, that you would be paying within some grace period. If you don't pay, they simply will deny any claims since you don't have coverage. You can call to cancel or simply never pay. Your insurance will be cancelled either way.
posted by JackFlash at 2:51 PM on January 19, 2015


But if your income when you applied was low enough so that the entire cost was fully subsidized, simply not paying wouldn't be enough to cancel it (since the government is paying each month for you.) And you could owe the full subsidized cost plus penalties (in April 2016) if the IRS were to determine you didn't report your change of income within a reasonable time (30 days?).

So definitely cancel it immediately, retroactively to the 1st of January.
posted by nobody at 2:54 PM on January 19, 2015


you may have to go through the Obamacare site (healthcare.gov) in order to cancel the coverage; this is how I was told to do it after I tried to called the insurance company to cancel directly. Also, technically you are obligated to contact the Obamacare marketplace if your financial situation changes; if you are getting coverage with a tax credit, you could be liable to pay this back during tax time next year.
posted by bearette at 3:12 PM on January 19, 2015


I have two health insurance plans currently, both paid for by employers (one is my own). It does get a little complicated, but it does come in handy when one plan falls short -- essentially the second plan covers any incidental costs, things like co-pays are paid 100% by my second plan.

One plan is enough, and if you are getting a second plan for essentially free or close to it, it's fine to keep double coverage, but if will cost you hundreds/thousands per month to have the second plan, it's probably not worth it.
posted by mathowie at 3:49 PM on January 19, 2015


Actually, if you are getting a Obamacare, it's not legal to keep it if you have insurance elsewhere. Obamacare is just for people who do not have/cannot afford insurance elsewhere, or have insufficient insurance and can't afford more. (and make too much to get Medicaid). So if you keep it, you may have to pay back/deal with it later. Best to call the number on healthcare.gov and cancel.
posted by bearette at 5:57 AM on January 20, 2015


if you are getting a Obamacare, it's not legal to keep it if you have insurance elsewhere.

This is not true. There are only three requirements for Obamacare:
1. Live in the U.S.
2. Are a citizen or legal resident.
3. Not currently in jail.

Anyone can buy an Obamacare plan. It is not just for people who do not have/cannot afford insurance elsewhere. It's available to everyone. However, in order to get a subsidy for your plan, there are certain restrictions on income and employer insurance. But if you don't want a subsidy, anyone can buy it.
posted by JackFlash at 8:53 AM on January 20, 2015


If you want, you can look closely at the coverage provided by both and figure out if the second plan is worth keeping. Your employer provided plan will be primary. If the second plan provides better coverage -- lower deductible, lower co-pays, covers a higher percentage of medical costs -- and the cost of keeping it is not prohibitive, it will introduce some hassles in terms of record keeping and the like, but what will happen is the bill will first get paid by your primary coverage and then any difference between the primary coverage and secondary can get paid by the secondary coverage. So if the secondary coverage is not better than the primary, it is not worth keeping because it will never pay a dime.

It is not illegal to have two coverages. It is actually a somewhat common situation if both spouses work. They can both be covered under each other's insurance from work, but will have a different order of primary and secondary coverage as the coverage from your own employer will be the primary and the coverage from your spouse's will be the secondary.

You only have a legal problem if you are trying to "double dip" by getting them to both cover it separately somehow instead of each of them cover what they are legally required to cover -- in other words, if you try to get one to pay the 80% it covers and the other to pay the 70% it covers such that you pocket 50% instead of one paying 70% and the other paying 10% so it totals 80% of the bill. That would be insurance fraud. As noted above, for major medical coverage, if you are getting checks back that exceed the amount you paid, you are doing something wrong somewhere.

(There are supplemental policies where it is not illegal to get a check back that can be more than what you paid, but that's a whole 'nother ball of wax, not directly related to this situation. I am just being pedantic because I worked in insurance for over 5 years, so I know there are situations where it is not illegal to be getting more back than you paid for the care.)
posted by Michele in California at 11:05 AM on January 20, 2015


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