This question is regarding the scenario where you have two commercial plans (not Medicare, Medicaid, or any state options). We live in North Carolina. My spouse and I both can have insurance through our employers and be on the other’s insurance.
I have received conflicting information regarding what determines which plan is your primary vs. secondary insurance.
My mom used to work in healthcare administration, but has been out of it for several years. She said that primary insurance is always whichever plan you are the primary plan holder on. I found a 2013 document from Anthem that says the same. However, it seems to be an archived printout and not a currently published page.
I spoke with Anthem’s Coordination of Benefits department, and they said whichever policy has the earlier start date is your primary, regardless of which policy you are primary plan holder of.
I would like to be confident that what Anthem’s representative said is correct; however, I could not find any information/documentation to confirm/supplement his response online.
Can anyone confirm that the start date drives which insurance plan would be considered your primary? Thanks!
I am concerned my question does not make 100% sense and want to further detail our scenario below:
Spouse 1 works for Company A and signs up for a PPO. Spouse 2 is already added to the plan.
Spouse 2 starts a new job at Company B and signs up for an HDHP, and also wants to add Spouse 1.
Spouse 2 wants Spouse 1’s PPO to be the primary insurance and the HDHP to be the secondary.
According to the Anthem rep, since Spouse 2 was already on the the PPO, and the PPO has an earlier start date, that will be Spouse 2’s (and of course Spouse 1’s) primary insurance.
If this is not correct, then we would reconsider signing up for the HDHP.
submitted by /u/EastCoastLo
[link] [comments]This question is regarding the scenario where you have two commercial plans (not Medicare, Medicaid, or any state options). We live in North Carolina. My spouse and I both can have insurance through our employers and be on the other’s insurance. I have received conflicting information regarding what determines which plan is your primary vs. secondary insurance. My mom used to work in healthcare administration, but has been out of it for several years. She said that primary insurance is always whichever plan you are the primary plan holder on. I found a 2013 document from Anthem that says the same. However, it seems to be an archived printout and not a currently published page. I spoke with Anthem’s Coordination of Benefits department, and they said whichever policy has the earlier start date is your primary, regardless of which policy you are primary plan holder of. I would like to be confident that what Anthem’s representative said is correct; however, I could not find any information/documentation to confirm/supplement his response online. Can anyone confirm that the start date drives which insurance plan would be considered your primary? Thanks! I am concerned my question does not make 100% sense and want to further detail our scenario below: Spouse 1 works for Company A and signs up for a PPO. Spouse 2 is already added to the plan. Spouse 2 starts a new job at Company B and signs up for an HDHP, and also wants to add Spouse 1. Spouse 2 wants Spouse 1’s PPO to be the primary insurance and the HDHP to be the secondary. According to the Anthem rep, since Spouse 2 was already on the the PPO, and the PPO has an earlier start date, that will be Spouse 2’s (and of course Spouse 1’s) primary insurance. If this is not correct, then we would reconsider signing up for the HDHP. submitted by /u/EastCoastLo [link] [comments]Read Morer/HealthInsurance