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Double Coverage Health Insurance
Old 02-03-2008, 12:53 PM   #1
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Double Coverage Health Insurance

For people under 65 and are 5-15 years from ER and have health insurance through an employer, a significant health care coverage problem exists.

Suppose your or one of your dependents develops a serious illness before you ER. After you quit your job, you may have 18 months of COBRA coverage, and after that, you must find health insurance on the open market. Depending on the seriousness of the illness of yourself or the dependent, you or the dependent will not be able to get health insurance in the private market. You only option would be a state high risk pool with high premiums and low lifetime maximums, if it exists in your state.

So it may be wise to lock in individual/family health insurance in your name (not through your employer) BEFORE your ER.
Two problems arise. First, most health insurers do not want you to have two health insurance policies. They end up fighting and neither will pay apparently. Second, keeping two policies is expensive.

Anyone have any solutions to this dilemma? Anyone know of any health insurance companies that will let you keep two policies? If one spouse is covered at work, can the other spouse get an individual/family non-employer plan and put their spouse and kids on it?
Seems like there should be a market solution for this problem.

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Old 02-03-2008, 04:48 PM   #2
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I've been double covered in the past with my own employer-paid insurance and my DW's family employer-paid coverage (hers was the better value). You can make claims on both. One will be primary and pay its full benefit. The other is secondary and will pay any difference between what the primary insurer paid and what the secondary insurer would have paid if it was primary.

There were simple birthdate rules for determining which was the primary insurance if it was not otherwise clear. We had that in effect for a few years, I think with two fully employer paid family policies. That's coordination of benefits, which seems very common.

I did once have to prove that I was no longer double covered, a few years after I had dropped my coverage from a particular carrier. The old carrier no longer had any record of me, so that was a whole lot of fun. Other than that we never had a big problem.


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Old 02-03-2008, 06:26 PM   #3
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Sounds like from other threads that all could be lost if you move to another state.
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Old 02-04-2008, 02:07 AM   #4
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I've just gone through a similar experience, and to add to the fun, one of the insurance carriers also stated that they would not do coordination of benefits. Being somewhat ignorant of the vagaries of insurance, I just thought that meant that we would have to file ourselves with the second carrier, once we got an EOB from the first carrier. Wrong!!!!!!
It apparently means, at least they explained it to me after many phone calls, that they would not pay. Even if we filed, they would not pay. I asked them why I should be paying their rates then, if they would not pay, and they said I shouldn't, but if I chose to, I could, but they still wouldn't pay. This was on my DW, since she had coverage from her former employer, and I was carrying her on my policy as well.
I don't understand how this can be done legally, since we are paying for coverage, and they should pay, but apparently they have some congress critter on payroll that permitted such a bad law to be passed. My opinion of course, and an expression of my frustration.
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