When it comes to health insurance, policy holders have two primary concerns:
Of course, you want the best coverage you can get, but you also want to pay the least amount possible. Your deductible refers to the portion that you are required to cover before your insurance will kick in and your provider will cover the rest of a health insurance claim. When you have covered the cost of your deductible for the year, your insurance company will cover any other claims that are filed within that year. But what happens if you are covered by two health insurance policies? How do the deductibles work?
Two Health Insurance Policies = Two Deductibles
If you carry two separate health insurance policies, you will be required to pay the deductibles on each policy before your insurance providers will cover the remaining costs of any claims that you file. For example, if you have two separate surgeries and one procedure is done under one insurance policy and the other is done under the other policy, you will be required to pay the deductible for both policies before either one of your insurance companies will kick in and cover the rest of the expenses.
Claims Must be Filed with Your Primary Plan First
If you are covered by two health insurance policies, it’s important to note that you can’t pick and choose which one you will file a claim with. Any claims that you make must first be filed with your primary insurance provider. As such, you will need to meet the deductible on your primary policy before your insurance provider covers any of the costs. If you do file a claim with your secondary policy, you will then also have to meet the deductible on that policy before your insurance provider kicks in and covers the costs that are associated with that claim.
If, however, your primary policy will not cover a specific medical procedure that you require, you can file a claim with your secondary policy. You can also file a claim with your secondary insurer if your primary insurer only covers a portion of a procedure. It’s important to note, however, that while your secondary insurance will cover any expenses that your primary policy does not cover, it will not cover the cost of the deductible for your primary coverage.
Which Plan is Your Primary Health Insurance Policy?
If you have employer-sponsored health insurance and another form of coverage, the policy that is provided by your employer will be considered your primary policy. For example, if you are a member of your employer’s group health insurance plan and you still have coverage under your parents’ health insurance policy, your employer-sponsored plan will be considered your primary policy. The same is true if you have employer-sponsored health insurance and you are also covered by your spouse’s health insurance; your employer’s health insurance plan would also be your primary insurance and your spouse’s plan would be your secondary policy.
Important Factors to Note
If you are carried by two separate health insurance policies, in addition to the way in which deductibles work, there are other factors that are important to note. For example, you should never attempt to file a claim for the same medical procedure with both your primary and your secondary insurance provider. Doing so is illegal and serious ramifications will likely follow. But, it is a wise ideal to make sure that you take the time to coordinate coverage with both your primary and secondary providers. Doing so will allow you to ensure that you are receiving the best possible coverage without paying more than you need to.
Summing It Up
It is possible to be covered by two health insurance policies. However, if you are, it’s important that you understand how deductibles work for each plan. Should you file claims with both policies, you will need to pay the deductibles on both policies before your providers will cover the rest of the costs that are associated with your claims. If you are unsure of what your deductibles are, speak to a representative from your health insurance companies.