Can I Have Two Health Insurance Plans?

Having two health insurance plans allows you to plan for the unforeseeable future by having two plans that will pay for coverage. For most people, one health insurance plan does not cover everything you need, some only allow you to visit in-network providers, others may have high deductibles, etc. You can purchase secondary insurance independently or through your spouse’s plan to avoid high medical bills. Your primary insurance covers basic medical expenses like lab tests, physician visits and prescription drugs while a secondary health insurance plan can offer additional benefits for services your primary medical plan doesn’t cover. Having multiple health insurance plans creates coordination of benefits which establishes an order of claim payments that avoids duplicate payments.

On This Page

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  Why Would You Need Two Health Insurance Plans?

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  How Does It Work When You Have Two Health Insurance Policies?

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  How To Determine Which Insurance Is Primary and Which Is Secondary

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  Are There Still Out-Of-Pocket Costs With Two Health Insurance Plans?

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  What Are the Pros and Cons of Having Double Coverage?

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  FAQs

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  Get Help Finding a Second Health Insurance Policy

Why Would You Need Two Health Insurance Plans?

With dual health insurance plans, one is considered “primary” while the other is “secondary.” Having dual health insurance plans can sometimes reduce your out-of-pocket costs, but other times the additional deductible and premium payment can increase your costs overall.

Dual health insurance plans are a common option for seniors to help reduce the cost of medical expenses beyond what Original Medicare provides. Adults may add a secondary health plan for dental care that their primary insurance doesn’t cover. Parents may decide to add additional coverage and accidental injury protection for their sports-loving teenagers in the case of injury. Anyone can benefit from two health plans, especially if you receive coverage through your employer, spouse, or parent’s plan. If you or your spouse needs a long-term care facility, it makes sense financially to have a secondary health plan that can shoulder the extra expenses.

There are various reasons people may want two health insurance plans, such as:

• Extra help with medical bills: Dual coverage lets you access two different health plans to cover your healthcare costs; for example, if your primary plan has a copay or deductible, your secondary plan may pay for it.
• Peace of mind: If you have insurance through your employer and are also covered by your spouse or your parents, you don’t have to worry about losing your work insurance if you lose your job and the health plan attached to it since you have additional coverage from your spouse or parents.
• Receive more coverage: You maximize your benefits with two plans.
• No interruption in benefits: If you lose your job and employer-health plan, you can still rely on your secondary health plan.

Policyholders may want two individual private insurance plans to help cover services that Original Medicare doesn’t cover, and it can help pay your out-of-pocket costs for copayments, deductibles and coinsurance. Not everyone wants to have work-related insurance or be covered through their spouse or parents. Members get extra financial help with prescription drug coverage, illnesses, injuries and more. Supplemental insurance also provides cash payments to offset members’ out-of-pocket costs for intensive care, cancer treatment, heart attack, stroke, accidental injuries and hospitalizations.

Having dual coverage can be beneficial if the savings you receive outweigh the costs (premium and deductibles) because of the two plans’ differing cost-sharing rules. Your secondary plan may pay some or all of your out-of-pocket expenses from the first plan, and it can cover services the primary plan doesn’t. However, your secondary plan may not cover all the costs that your primary plan doesn’t pay, and handling two separate plans can be complicated. Think about your current and future healthcare needs, then estimate if the cost of the two plans’ premiums, deductibles, and other expenses outweigh the benefits and extra coverage of having dual plans.

There are three main scenarios for having dual health plans.

1. You and your spouse or domestic partner both have healthcare through your employers or a shared private insurance plan. You could also have coverage through your own plan.
2. You are under the age of 26 and have healthcare coverage through your employer or your college or university and you are eligible to be added to a parent’s health plan as well.
3. You are a child and both parents list you as a dependent on their health plans.

Private insurance plans can help you maximize healthcare benefits with dual coverage that can address vision, dental, hospital stays, accidental injuries, cancer treatments, life insurance and more. By shopping around, you may be able to find low premium plans that fit your needs and budget. You can also ask your provider how much it would cost to add an additional plan. For most members, having two private insurance plans means additional coverage that outweighs the double premium and deductible. Secondary insurance can fill in the gap for your primary insurance and provide the additional coverage that you need, especially if you help with hospital stays, vision, dental, medication and cancer treatment. Plus, you can try it for a while and decide that it is not for you, you can always switch back to having a single healthcare plan.

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How Does It Work When You Have Two Health Insurance Policies?

Having two health insurance policies doesn’t mean you get reimbursed twice for your doctor’s visit. Instead, it ensures that your claims are covered and you receive the healthcare you need.

Primary insurance

Your primary insurance is the insurance that pays first up to coverage limits. It covers your basic medical costs like:

• Lab tests
• Doctors’ visits
• Prescription drugs
• Yearly exams
• Vaccinations
• Pregnancy care

Secondary insurance

Once your primary insurance has paid its share, your secondary insurance covers all or part of the remaining bill. Secondary insurance is typically under a parent’s or spouse’s plan, or it can be a separate health plan that you purchased to extend your coverage which is often called supplemental coverage.

The two insurance plans work together in what’s called a coordination of benefits. You receive payments for healthcare services from both health plans, but you will still have to pay out-of-pocket costs for deductibles and premiums for both plans. There are specific rules, or coordination of benefits, about which of your plans will pay first when you visit a doctor, get a prescription filled, go to the ER or have a medical procedure done. The insurance companies will determine the coordination to make sure that neither overpay and to avoid duplication of benefits.

How To Determine Which Insurance Is Primary and Which Is Secondary

When considering primary and secondary insurance, there are certain rules about who pays first depending on the situation. For example, if you’re a dependent with two parents who both cover you under their health insurance plans, your primary insurance is decided by “the birthday rule.” This means that the primary coverage comes from the parent whose birthday comes first in the calendar year. When you file a claim, your primary insurance will provide you with your benefits regardless of your secondary plan. Then your secondary plan kicks in and covers some or all of the remaining cost. The following chart goes over a few common scenarios determining primary versus secondary coverage.

Are There Still Out-Of-Pocket Costs With Two Health Insurance Plans?

Yes, there are out-of-pocket costs with two health insurance plans. Keep in mind that the combined coverage can never exceed 100% of the cost. Also, having dual health insurance plans doesn’t automatically mean you won't have to pay anything out-of-pocket. You will still have to pay for any cost-sharing under your policy rules, including applicable deductibles, co-payments, coinsurance and premiums for both plans.

Bear in mind that plan rules still apply if you have multiple plans. For example, if you’re in a Preferred Provider Organization (PPO) plan, your primary plan may have provider network rules. If you go with an out-of-network provider who isn’t covered by your plan, your primary insurance will not cover the costs, and your secondary insurance won’t cover the costs since you didn’t abide by your primary plan’s rules.

What Are the Pros and Cons of Having Double Coverage?

Pros

Double coverage can help you maximize healthcare benefits: you get more coverage than you would with just one plan. When someone buys their own health insurance plan, they get to choose a plan that best suits their budget and needs, and are less likely to pay out-of-pocket for healthcare that isn’t covered by their plan and for benefits they don’t need. Plus, they can verify their preferred doctors, hospital facilities and medications before signing on. Since your coverage isn’t tied to your employer, you can easily change jobs without worrying about losing your health insurance coverage. Policyholders can also qualify for state or federal assistance in order to afford their insurance plan.

A big benefit to dual coverage is that you wouldn’t have to worry about losing health insurance coverage if you divorce, lose your job or change jobs: you always have another plan to fall back on. Another pro to having secondary insurance is that it helps you cover most if not all of your medical costs. For example, if one plan doesn’t cover a particular service, but the other does, you have more coverage.

Cons

A big con is having to meet two monthly premiums and two annual deductibles. Plans that are similar in coverage and rates may not end up saving you money. We recommend that you check each plan’s benefits and compare the premiums and deductibles and plan rules for each. Some questions you should consider include:

• Is one or both a private plan?
• Are they similar or very different?
• Are there out-of-pocket costs?
• Do they overlap?

Keep in mind that you don’t choose which health plan will be your primary, and you don’t get to choose which insurance provider will pay your claim.

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Get Help Finding a Second Health Insurance Policy

One of the best ways to lower your healthcare costs is to get a second health insurance policy and compare plan costs and benefits for the insurance you already have. Smartfinancial can help you find a second health insurance policy and coverage that fits your needs. To get started, just enter your zip code below and answer a few questions, or speak with a licensed insurance agent at 855.214.2291.