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How does it work with two insurance policies

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3 replies to this topic

#1 bilkarr

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Posted 15 April 2009 - 09:07 AM

How does having two health insurance policies work?
This is what I'm thinking, but I don't know. That is why I'm asking.

orginal amount 20,000
1st insurance, my share would be 3,400 (deductable & out of pocket)

2nd insurance total would be the 3,400
now here is what I don't understand how it works. Would 2nd insurance pay the 3400 in full. Or would I still have to pay the 20% of the 80/20 share? Leaving me to pay 680.00??

Does anyone have any knowledge on how two insurances work?

#2 philly1030

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Posted 15 April 2009 - 05:40 PM

my guess would be that you would be responsible for the 20%. untill the total out of pocket is met and then it would pay at 100%.

Some insurances will pay the whole amount. it all depends how the second insurance plan is set up.

#3 ZeroScore

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Posted 15 April 2009 - 05:45 PM

Second what Philly1030 said. Some insurance companies will add benefits together, some will not - I currently am dealing with some medical bills for my children, my insurance (primary) covers $1200 on a particular service, ex's covers $1000 - BUT, if they are secondary, the cover whatever the primary did not cover up to their $1000, so in my case the secondary doesn't cover a cent.

#4 ez2nve

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Posted 29 April 2009 - 10:49 PM

I'm actually in the process of trying to figure this one out myself. From what i'm being told it's different than what i assumed; which was that the Primary plan would cover part and the secondary would cover what's left, paying the claim at 100%. After speaking to someone with the state and a rep with the insurance company, they told me that it depends on what the percentage is....for example in network is paid at 80% for the primary, if the secondary covers 85% in network, then on any particular claim the secondary would only pay an additional 5% outside of what the primary pays. If they were both paid at 80% in network, then the secondary wouldn't have to pay a cent.

Only an approved amount is applied to the deductible, after that's satisfied, then it may be paid at 80% (in network) even higher out of network. When deductible and co-insurance equal the out of pocket maximum, then it's paid at 100%......OF THE ALLOWED AMOUNT for the remainder of the plan year. Hope this helps

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