Health Insurance Benefits Double Coverage

The current state of health care has many people exploring the benefits of health insurance double coverage. Double coverage is when one individual is protected by two or more health insurance plans. This situation most often occurs when both partners in a relationship are insured by their respective employers or when divorced parents both carry health insurance for their children. Double coverage can also apply to persons who have a primary health insurance policy, and have health insurance benefits through membership in an association or organization; are unmarried dependent children who take part in employee sponsored insurance plans; and those with certain automobile insurance policies.

Filing a Health Insurance Double Coverage Claim

• When a person has health insurance benefits double coverage, payment of claims is determined by an industry standard called coordination of benefits (COB). COB information is typically included as part of your health insurance policy, and is used to decide which company holds the primary plan and how claims will be paid. According to the guidelines set by the National Association of Insurance Commissioners, the primary health insurance plan:

  •  Lists the patient as the policyholder.

  •  Covers an active employee of the group company.

  •  Is not a temporary continuation of coverage policy.

  •  Has insured the person longer.

  •  Is provided by the custodial parent of a dependent child.

  When a person with health insurance benefits double coverage submits a claim, it first goes to the primary provider, which pays it as if there is no additional coverage. Then the secondary plan pays the balance as long as the treatment is covered under that plan, and the payment does not exceed the total amount of the claim.

Pros and Cons of Health Insurance Benefits Double Coverage

Double coverage health insurance benefits cast a wide safety net, but it is important to understand how the policies will work together and coordinate benefits. While double coverage can offer peace of mind, it can also be expensive. Comparing the individual and combined benefits of the policies will ensure that maintaining both makes financial sense, and the benefits received will exceed the premiums paid.

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