Background:
I did not have the option of healthcare through an employer from 1/1/2021 – 6/30/2021. In November 2020, I enrolled in a policy through healthcare dot gov (HDG) effective 1/1/2021. As of a couple weeks ago, I am also covered through my new employer effective 7/1/2021. My employer policy runs July-June. Otherwise, I would’ve delayed and enrolled for January.
I have met my OOP max for my HDG policy; I have $8k to go for my employer policy. Both policies are currently active. The HDG policy has been subsidized and I am aware that I am ineligible for premium assistance as of 7/1.
What is happening: I have surgery scheduled for September 1. The hospital is in network for both plans; however, it’s a highly specialized field and my surgeon doesn’t take insurance so I will be paying him out of pocket. I can barely cover this and it is a serious financial stressor, so I need as much insurance coverage as possible on the rest of the procedure.
My rationale: My HDG coverage would save me thousands on hospital bills because my OOP max is met. My employer coverage offers coinsurance for surgeries out of network, so could theoretically cover some of what I am paying the surgeon.
My concerns: 1. Can I be the primary insured on two private policies at once? 2. If yes, how will primary vs. secondary coverage be decided? 3. If I can only use one policy, I want to use my HDG policy; if I can only HAVE one policy, I will have to drop my HDG policy because I’m locked into the employer policy.
I’ve found all kinds of articles on being covered under two insurance policies, so I know I can’t be reimbursed twice for the same cost, how primary/secondary is decided in common situations, etc. But I can find no info about being the primary insured on two private policies, whether it’s permitted, or how primary/secondary is decided. So, here I am, hoping someone can help. Any assistance is greatly appreciated.
submitted by /u/_banditqueen
[link] [comments]
Background: I did not have the option of healthcare through an employer from 1/1/2021 – 6/30/2021. In November 2020, I enrolled in a policy through healthcare dot gov (HDG) effective 1/1/2021. As of a couple weeks ago, I am also covered through my new employer effective 7/1/2021. My employer policy runs July-June. Otherwise, I would’ve delayed and enrolled for January. I have met my OOP max for my HDG policy; I have $8k to go for my employer policy. Both policies are currently active. The HDG policy has been subsidized and I am aware that I am ineligible for premium assistance as of 7/1. What is happening: I have surgery scheduled for September 1. The hospital is in network for both plans; however, it’s a highly specialized field and my surgeon doesn’t take insurance so I will be paying him out of pocket. I can barely cover this and it is a serious financial stressor, so I need as much insurance coverage as possible on the rest of the procedure. My rationale: My HDG coverage would save me thousands on hospital bills because my OOP max is met. My employer coverage offers coinsurance for surgeries out of network, so could theoretically cover some of what I am paying the surgeon. My concerns: 1. Can I be the primary insured on two private policies at once? 2. If yes, how will primary vs. secondary coverage be decided? 3. If I can only use one policy, I want to use my HDG policy; if I can only HAVE one policy, I will have to drop my HDG policy because I’m locked into the employer policy. I’ve found all kinds of articles on being covered under two insurance policies, so I know I can’t be reimbursed twice for the same cost, how primary/secondary is decided in common situations, etc. But I can find no info about being the primary insured on two private policies, whether it’s permitted, or how primary/secondary is decided. So, here I am, hoping someone can help. Any assistance is greatly appreciated.
submitted by /u/_banditqueen [link] [comments]Read Morer/HealthInsurance