Can I link my health insurance & hubby's?

Factual Questions
1

Hubby DeathLlama and I both have medical insurance through our jobs. Mine is an HMO where we have to pay the family rate–this was the vote last year. Even though some are single with no dependents, they need to pay the same amount as someone married with six kids. Anyway, because of that, both DeathLlama and RuffLlama were added to my plan, but neither have ever actually used my insurance. DeathLlama has a PPO plan, which despite paying out of pocket, has been preferable as we don’t have to do the referral song and dance. RuffLlama was placed under hubby’s plan because of the PPO flexibility, but also because the pediatrician’s office apparently just goes with whichever parent’s birthday comes first in a calendar year.

It seems like there should be a way to link the two–perhaps have one be secondary insurance to the other–so we can avoid copays and the like. But, these are two different insurance companies (Blue Cross and Blue Shield) and two different types of plans (PPO and HMO), so I don’t know how feasible that is.

With baby #2 on the way, we’d obviously like to save some money–but also get the best coverage we can.

2

I used to work in the benefits industry. It is a bad idea to mix those types of plans in general. You can easily get into a cross-fight between insurance companies regarding who is going to pay if something goes wrong. The standard answer is to just pick the best one for your needs (I would choose the PPO personally) and drop the other.

3

I’m not an expert but I worked with benefits at my last job. There was no benefit to carrying two plans. If the plans were “comparable”, for example, each plan paid 80% after the deductible, you can’t use Plan2 to make up the 20% that Plan 1 didn’t cover.

I hate to suggest this, but the only way to know for sure is to read your plan documents. There should be some info about comparable coverage. Read it just before bed – it’ll put you right to sleep. :slight_smile:

Or talk to someone in your benefits department.

4

Good info, Shagnasty and Auntie Pam. I’ll call my HMO Monday and see if I can drop my son and hubby–the enrollment period has ended, but maybe they’ll make this sort of adjustment. Also, when baby #2 is born, we’ll make sure he goes under DeathLlama’s insurance as well. Maybe if we had the same company, even if not the same plan, it’d be more feasible. But–the LAST thing we need is the two of them bickering, “YOU pay!” “No, YOU pay!”

Seems silly; I mean, I’m paying for all of us…but I’d like to avoid the insurance battle drama if I can.

5

We’ve occasionally had dual health insurance.

The way it worked was, you’d submit (or the provider would) to plan 1. They’d pay. Then you could take the provider bill and Plan 1’s EOB and file a claim with plan 2.

Then Plan 2 might pay something.

Say your bill is 100 dollars, and plan 1 pays 80 dollars.

It used to be, if plan 1 paid 80 dollars, you could file the claim for the remaining 20 dollars with plan 2. They’d treat it as a new claim, and say they could pay 80%. But they’d see that plan 1 had paid 80 already, with a remaning balance of 20, and they’d pay the 20.

Then later on they started treating it as “well, we’d only pay 80 bucks. The other company has already paid that, so too bad, so sad, you don’t get a dime from us”. In other words, we (or my husband’s company) had paid for the coverage, and we got nothing for it.

Who pays for your kids (in your current situation) depends I think on whose birthday is first. I believe your own coverage covers you first, your husband covers him first, and your kids are dependent on the birthday. Not sure whether it’s who’s older, or whose birthday is first in the year (e.g. you’re 40 but born in June, your husband is 42 but born in August).

In general, it’s now very rarely worth carrying dual coverage (because of the too bad so sad scenario).

Sucks that at your workplace, you pay the same regardless of family size. Am I correct in guessing that people with families outnumber single people? I don’t blame you for keeping the kids under your plan as well in that situation.

I’d actually be inclined to keep them under your plan, despite the HMO referral hassle, as it’s essentially “free”. Or, drop your own coverage entirely and get your spouse to cover you all.

You won’t be able to get them dropped right now if it’s not open enrollment time. You may be able to do so after the baby is born, as that qualifies as a life event.

6

Moving thread from IMHO to General Questions.