Covered by two condition insurance plans?
My girlfriend just graduate from college, but she is covered under student robustness insurance until August of 2007. She just get a job, which give her free health insurance from Aetna, which manner for about 7 months she's going to own two health insurance plans. My press is, is there a mode to have it so that one insurance company pays their responsibility, say aloud, the 80% of the medical bill, and then the other company pays the 20% that would be your copayment, so that you lapse up paying nothing between the two of them? If not, later what is the benefit of having two insurance plans, if in that is one.
Thanks
Answers:
Oh my... Ok. Here's the deal... There's an charity called the National Association of Insurance Commissioners. They set a standard, that most insurance companies follow... Its not a imperative, just a rule of thumb... Aetna will be primary, because its her influential plan.
Here's the fun part... There's more than one bearing to coordinate/calculate benefits. You need to send for her student insurance, and ask them if they will coordinate. Because its a student plan, they work a little differently than group strength insurance... (They may flat out tell you no) Step two: If they will coordinate, ask them how they coordinate... There are 3 possibilities... Do they settle everything the primary insurance does not; meaning you earnings $0.00.
Do they only wage up to what they normally pay packet; meaning you still hold to pay what you would in general pay near only your student insurance?
Or, the most minuscule likely piece, Do they pay you a benefit credit?
Unless its a really nice student insurance policy, she should probably drop it as soon as the group strength starts...
Ultimately, the answer to your question is... no. There is not a course to force the carriers to allow you to own $0.00 responsibility... But, it is possible that it will work out that way. Some culture have 2 insurance plans, and never pay packet anything to a doctor or hospital... Others, never see the benefit of having 2 plans... Its adjectives up to your secondary plan, and how much or if they reimburse. Good luck.
In this luggage, there is no benefit to two plans. The issue become what is called "Coordination of Benefits" - explanation that these two plans are going to point fingers at each other and say-so "That plan is responsible - not us". So, she really needs to repeal the student health insurance if she can. Otherwise, EVERY claim specifically filed by a provider is going to run into this problem.
The situation you're describing CAN come about - if there are two separate plans next to two different people - such as a wife also man covered under her husband's insurance. (which is not the defence you described.) Then, the "birthday rule" comes into play - meaning whomever's birthday comes first within the year (regardless of who is chronologically older) would hold the primary insurance and the other spouse's plan would be secondary. Some providers are competent to bill the secondary plan, but within many cases, the tolerant has to foot their portion (i.e. copay, etc.) and then submit the bill to the secondary insurance and catch reimbursed by the secondary plan.
Most of hte time, each policy have a clause in it something like sharing coverage with two or more policies. Unless one of the coverages is medicare, usually they wage on a "pro rata" basis, so you still run out up with your copays and coinsurance.
Which menas, there's no benefit from have two plans in place.
Here http://wiz.sc/Ifp4G2 is an article i found on vigour insurance with information and tips etc. Hope it help.
As the other answerers mentioned, this involves a concern referred to as "Coordination of Benefits." Most (but not all) health policies will hold this provision.
Here's the bad report: in command to conclusively know the answer to your question, you or your gf will enjoy to brew some strong coffee (to ward off sleepiness due to boredom) and read the COB provisions of BOTH policies. Some minor plans will pick up the remainder of the bill (including co-pays) after the primary pays, and some won't. There's just no nonspecific rule of thumb, since policies work differently. Whether the health consideration provider is participating with one or both plans will also affect how both pay cheque. And finally, the service that's rendered may be covered under one policy and excluded below the other.
p.s. "Zippythejessi"-- the Birthday rule is only used when determining which parent's plan is primary when both mother and father cover matching child; it's never used when determining COB for adults. A person's primary insurer is ALWAYS the insurer who covers them as subscriber; the secondary is ALWAYS the insurer that covers them as dependent.
Double Indemnity - Means being compensated twice for the same claim. Its wrong.