Is it illegal to have two health insurance policies? Health insurance is a regulated industry. Insurance companies must follow certain rules and regulations to legally sell their policies and services. If they don’t, they risk having their licenses revoked by regulators. This means that several health insurance companies will not be able to offer you coverage when you need it most, which can put your well-being at risk.
It’s important to understand what it means if there is more than one health insurance Company offering the same type of plans in your area. Understanding the implications and risks will help you make the right choices for your situation.
Is it Illegal to Have Two Health Insurance Policies?
You can use two health insurance policies. Dual eligibility for health insurance plans is fair. That’s why many people have multiple health insurance policies. You must meet certain requirements.
It is possible to have two health insurance plans for a variety of reasons, including:
- Your parents and employer insure you if you are under 26. You have health insurance coverage for employers (even married).
- You are 26 or less and live with your married parents. Each of them has a separate health insurance policy. So, both parents have you listed as they depend on their health insurance policies.
- In your early twenties, you live with your separated parents. So, both parents have declared that you are an unmarried dependent on their separate insurance policies. The age of your spouse’s plan and the program offered by your parents covers you. Remember that this applies if you are under 26.
What it’s like to have multiple health insurance policies
Multiple health insurance policies do not imply receiving reimbursement twice for the same doctor’s visit or twice for the same prescription. It is critical to understand the distinction between primary and secondary insurance.
This applies if you pay for more than one health insurance plan. Specifically, this is where primary insurance differs from secondary insurance.
- Primarily, you have “primary” insurance. It pays out first and will reimburse you up to your policy limits. A cost-sharing obligation may be owed to you.
- Your “secondary” insurance pays the remaining bill if you have more than one health plan after your primary insurance has produced its share of the cost of care.
Having two health insurance policies is ok?
For example, if you have two health insurance policies, you’ll be responsible for paying both plans’ premiums and deductibles. You will not apply your secondary insurance payment to the deductible on your primary insurance policy. You may owe additional copayments or self-capital expenses, such as coinsurance.
Multiple health insurance policies have both advantages and disadvantages
Aside from that, if you have health insurance through your parents or your partner’s plan, you won’t have to worry about being without coverage if you lose your job and the health insurance that comes with it.
In addition to maximizing benefits, having two or more health insurance plans can allow you to receive additional coverage that is not available with just one insurance policy.
Keeping you covered under your parent’s or spouse’s insurance at a low or no cost is a good possibility in most cases (some employer-sponsored plans offer family coverage at a flat rate and not per dependent).
Differences between Primary and Secondary Coverage
|Primary coverage||Secondary coverage|
|Primary medical insurance is the first type of health insurance to be activated and utilized, with claims paid as though it were the only policy in effect.||Secondary insurance covers any remaining costs after primary insurance has paid a claim.|
|Primary insurance seeks to pay all medical bills for the amount contained in the policy.||Secondary coverage is triggered when the expenses of the first coverage reach their limit, and you continue to need medical care or pay deductibles.|
|Primary coverage has its conditions of use; sometimes, insurance companies may deny service requests.||Secondary coverage, in this case, may pay for a portion of the process based on what the coverage can cover under the contract.|
|Primary coverage will be triggered to cover standard expenses incurred for medical care needed by a patient.||The expenses that remain to be paid are those that are part of the second coverage.|
|In the case of vehicles, primary coverage covers the driver.||The secondary coverage covers, in cases of vehicle policies, the other persons riding with the driver (in case the primary coverage has covered the driver entirely).|
We have discovered that understanding the difference between primary and secondary insurance can be challenging. As a licensed insurance broker, eHealth can offer various health insurance plans from reputable insurance providers.
Having dual insurance is also common among students who may be enrolled in a student or university plan under 26. Therefore, they are eligible to be covered under their parent’s health insurance plan.
Two separate insurance policies may also cover the children of divorced parents. One issued by their mother and another by their father. One more example is those who qualify for Medicaid and have insurance plans to supplement their Medicaid protection. Individual market plans or plans provided by an employer are both options.
What happens when more than one health insurance company offers the same plan?
Health insurance companies can only sell one type of health coverage per state. If more than one company sells that type of health plan in your area, finding a plan that works for you could be challenging. This is important to remember when you’re shopping for a health plan. If you’re looking to switch health insurance companies, keep in mind that you will also have to switch plans to get what you want.
Now that you know why there can be more than one company selling the same plan let’s look at what happens when there is more than one health insurance Company offering the same plan. If you have a pre-existing condition or are already sick when you shop for health insurance, you may be at a disadvantage when there is more than one health insurance Company offering the same plan. One plan may have a higher risk rating for you, and one may have a lower risk rating.
If you end up being denied coverage by one company, you may be able to switch to another plan and get coverage. But the challenge here is that the companies are not allowed to discriminate against you because of your condition, so you may have to prove to the new company that you have a serious health condition.
Lastly, keep in mind that if you switch plans, you’ll have to change your financial and medical information.
Under the Affordable Care Act, health insurance companies can no longer sell discriminatory plans.
Health insurance is supposed to be a way to protect you and your family if something goes wrong. Health insurance companies used to be able to charge you more if you had a pre-existing condition or if you were already sick when you signed up for coverage.
These so-called “discrimination” rules were eliminated under the Affordable Care Act. The insurance company will not charge you more if you have a pre-existing condition. Instead, your coverage is guaranteed to be the same, no matter which company you go with. Coverage is also guaranteed to be the same regardless of which company offers you coverage first. Also, federal and state law prohibits insurers from unfairly dropping people from their health plans due to health status. If you have a serious health condition, you can find a health insurance plan that will accept you.
If a health insurance company offers you a plan that’s not compliant with the ACA, your options will be limited.
When a health insurance company offers you a plan not compliant with the Affordable Care Act, your options will be limited. If you are denied coverage or charged more due to a pre-existing condition, or if you are offered a plan with a significantly higher risk rating, you may not be able to switch plans. In this case, you will likely be required to shop for a different, non-ACA-compliant plan.
This can be a challenge because many people do not realize this until they are already sick and out of options. You’ll have to change your financial and medical information if you switch plans. If you switch plans, you may also face a longer wait time to see a doctor.
Health Insurance Companies Can Only Offer You Coverage If They Are Licensed to Do So
Health insurance companies must have state regulators’ licenses before offering any policies. The state regulator can revoke the license of an insurance company that does not comply with state laws. The easiest way to know whether or not a health insurance company is licensed in your state is to call the state health department.
You can find the phone number for your state health department by visiting the official state website. You can also search online for your state health department. If a health insurance company sells policies without a license, the state regulator can tell you whether or not the company is licensed.
If you discover that a health insurance company is not licensed but selling policies, you should immediately switch to a different plan.
Health Insurance Companies Cannot Sell Plans Off-Exchange.
Health insurance companies can only sell coverage if they are licensed. This is called an “off-exchange” plan. Suppose you receive health coverage through your job, Medicare, Medicaid, or a military health plan. In that case, you are probably covered by one of these programs and have already enrolled in that coverage.
But if you have a choice in whether or not you want to purchase a health plan through the exchange, you are eligible to shop off-exchange. Remember that you will not be eligible for subsidies if you shop off-exchange.
If you decide to shop off-exchange, keep in mind that you will have to pay a higher premium. You will also have to pay the penalty if you do not buy health insurance or if you cancel your policy after the year begins.
What happens when there are multiple health insurance providers in your area?
In areas where multiple health insurance providers are available, it’s important to shop around and ensure you get the best deal. If you have a pre-existing condition or are already sick when shopping for health coverage, you may be at a disadvantage when there is more than one health insurance Company offering the same plan.
This can be a challenge if you are denied coverage by one plan and are required to switch to another non-ACA-compliant plan. If you find a plan that works for you, it’s important to remember that it may not be available for long. The truth is that health insurance companies are not required to offer plans that cover your particular medical needs.
As the economy improves and more people buy coverage, your particular plan may no longer be available. You may even face premium increases in the future because of this trend.
Multiple Coverage Options and Risk Factors
Health insurance companies must abide by strict regulations and risk factors to determine whether they offer a non-discriminatory policy. If an insurance company fails to meet these standards, the state insurance regulator can take action and revoke the company’s license.
If a company has a history of discriminating or dropping people from coverage, it may have a risk factor of over 10% that impacts its customers’ premiums. Suppose a company does not meet the minimum requirements for covering all customers and has a risk factor that is too high. In that case, the state insurance regulator can take action and revoke the company’s license.
You may have to shop around more than once if you want a health plan covering your medical needs. Make sure you look closely at each plan’s rates to ensure you’re getting the best deal.
Network Differences and Risk Factors
Suppose a health insurance company is offering you a plan that covers a network of doctors and hospitals that is different from the networks that your current doctors and hospitals belong to. In that case, it’s important to understand the risks associated with this type of coverage.
If you are forced to change health plans because your current doctors and hospitals are not in a different health plan network, this could be a risk factor of over 10%. If you switch to a different plan because of a different network, you will likely have to change your financial and medical information.
Frequently Asked Questions
What is the relationship between two medical insurance plans?
As many consider, having two health insurance plans does not imply that you will get the full coverage twice per insurance plan.
It will be necessary to assign one as your primary plan and the other as your secondary plan, rather than having two separate goals. So the total amount paid by your two health insurance plans will never exceed 100 percent of the total cost.
Insurance coverage is the main option.
Your main insurance is the insurance that will pay for your medical expenses first. It works before any secondary insurance kicks in to cover the costs.
Your primary payer will pay for the bills for doctor’s visits and prescription fillings. It goes up to the limits of your coverage.
Insurance on top of that
Afterward, you’ll have secondary insurance to consider. This plan takes over as soon as you exceed your primary insurance policy’s coverage limits.
Is it a good idea to keep two health insurance policies is a good idea?
If you have access to two health insurance plans, you may pay less from your own money for things the first plan does not cover. Co-pays and deductibles are examples of expenses that may apply.
Are there any benefits if someone has two health insurance plans? To be precise, no! The coordination of benefits provided by two health plans does assist in better covering any healthcare costs that may arise.
If you believe that having only one health insurance plan will save you money, take the time to consider how combining care works and what healthcare costs you are likely to incur before signing a health insurance waiver and abandoning a second plan.
Your own job’s health insurance policy is free, and your partner can add you to their plan at a low cost. It would help if you kept both plans.
How can two different health insurance plans cover a person?
Parents have access to a health plan through their place of employment. Parents will receive coverage if they decide to include their children in both scenarios.
Married couples or domestic partners who each have access to a health insurance plan through their employer may choose to add each other to their respective coverage plans. Thebalance.com is the source for this information.
There are various reasons why two different health insurance plans might cover someone. These include being a young adult still on a parent’s plan and qualifying for Medicaid. Also, having two other health insurance plans with your spouse has numerous reasons.
Optional secondary insurance coverage is available to you if you so desire. And in some cases, having two insurance policies can assist you in paying for your medical expenses.
You will, however, have to pay two premiums and two deductibles when you have two plans. A deductible is an amount you must pay from your money for medical care before your insurance starts paying.
Additionally, when you have double coverage, there are additional considerations. Among them is the potential inconvenience of juggling two plans, each with its own rules and deadlines. Many factors influence the rules, including where you live and which insurance companies you choose to work with.
While coordinating your two health insurance policies may be difficult at first. So, if you follow the guidelines in this article, you’ll be well on managing two plans like a pro in no time at all.
Nicholas J. Banks has been an expert in the Insurance industry for over 10 years. He is well-versed in all aspects of insurance, and he has worked on Allstate Ins Group since 2006.
He attended the University of Pennsylvania with an undergraduate degree in Business Administration, followed by a Master’s degree from the University of Southern California to further his career in Insurance Management.
His experience working with many different companies has helped him develop valuable insight into how to succeed in this exciting field, which he now shares through our blog “Pro Insurance Info.”