frambuesas

Hello all,

Long time no see! Apologies for total absence from this forum; I guess I'm lucky that expat life started to get in the way in a "normal" sense, and run-of-the-mill things like jobs and date nights and car trouble started being more the focus than total bewilderment at being in a new culture.

Anyway...! I have a question. I have been fortunate enough to get a job that offers me health insurance. It's a state job so the health insurance is affordable for me (gets a bit ridiculous if you add my husband in, but that's currently not an issue) and would mean I am completely independently covered with a low copay, reasonable deductible, and a wide range of providers from which to choose.

I have to decide whether to join the insurance plan offered by my employer within 30 days of my start date. If I want to join after that, I have to wait until January each year (so my next opportunity would be Jan 2014, then Jan 2015 and so on). I am currently covered by my husband's plan, which is absolutely fantastic: no copay, and 80:20 coverage for pretty much everything, dental and vision all very reasonable, and the monthly fee for this is insanely low for what we get.

The reason I am a little concerned is if he decides he wants to change jobs. It isn't likely to happen any time soon as he likes his job and hasn't been there too long, so it would seem sensible to stay with his plan because it is quite a lot better than the one my new job offers me. But I am mindful of the fact that he might change or be offered a different/better position somewhere else and that could leave me without cover/paying a new policy that isn't as good as the one my work offers (I would not expect him to stay in his current job just because of health insurance red tape). My employer's cover states that I am only allowed to join their health insurance plan at an out-of-window time of year if my husband were to lose his job or to get a new job that simply wouldn't cover me at all - not if the cover was minimal, or cost too much etc. Add to that the proviso that if there's any period of my not being covered at all before joining my employer's policy then pre-existing conditions cannot be covered, and I am in a quandary!

Essentially I am asking if, as expats, you would recommend having your own health insurance regardless of how good your spouse's policy may be. Is this something anyone has dealt with before? Or should I just risk it and hope that, if he does change jobs, the new policy he has will be good enough or that the timing will be right?

Thanks in advance for your thoughts!

scrubbedexpat097

No problem having 2 insurances. Sometimes it helps, what the primary insurance doesn't cover the secondary might pick up.

Do you have to pay towards your insurance or do the company pay it all?

frambuesas

I have to pay $26 a month and they pay the rest. That's not going to cover dental or vision, but I can add those in. The important thing is getting on the plan at all, I suppose. So it's OK to have two? I may just go ahead with that, then!

penguinsix

I had two plans once and I got a note from both saying "what are you doing?". There was a form I had to fill out declaring one of my plans as the primary plan or something. Was pretty annoying.

As for the original question, if your husband loses his job, you might be able to COBRA pay for his plan for the next few months until your 'open season' is available for your plan. Note: COBRA is quite a bit more expensive as you pay both your share and the employer's share of the insurance, usually.

frambuesas

Huh! I wonder if it just depends on the specific insurer as to whether they are OK with a client having two plans. Will have to look into that. Thanks for the info on your experience!

If my husband loses his job or changes to a job that doesn't offer insurance/insurance for spouses then that is fine: my work insurance will open a special window for me to join (it's a "life event exception" cause). But if he gets a job with some insurance that is more expensive or less comprehensive etc. then I have no choice but to go with that until the window opens again at my job. It's not the worst thing in the world, but it's worrying me, hence the need for advice!

Michael

All insurers allow for primary and secondary insurance. They ask about a second plan because one is designated as primary and the other is designated as secondary and they need to know how to coordinate benefits and to also make sure you don't receive more than 100% reimbursement for treatment. It's a little complicated so do a Google search for "primary and secondary health insurance rules" and/or "coordination of benefits".

Duncan Roberts

That's not legal. There are several ways to get on a group policy out of the open enrollment period, losing your current insurance because you are a dependent on another group plan is one of them - regardless of the reason. Unless your employer has an insane qualifying period (like years) then there would be no wait period since you would be able to pick it up immediately so you wouldn't have to worry about pre-existing conditions.

In my opinion secondary insurance now is pretty much a waste of money unless you have very large out of pocket expenses. The plan that's right for you can only be decided by you. It may make sense to be on two separate plans but generally it doesn't because the premium cost outweighs the benefits.

frambuesas

I don't know that it's not legal - it might be a state-by-state thing? I'm not sure. But it seems legit from everything I've read about NC regulations!

I can definitely get on if my husband loses his insurance but I can't just change to my employer's plan because his insurance becomes less beneficial to me for whatever reason. Basically if I have insurance with him, it doesn't matter if I would prefer to have my employer's insurance, I have to wait until the window opens again.

As long as there's no gap between insurance plans, you are right, there are no pre-existing condition restrictions. However, given that the window only opens for thirty days once a year, it's a little bit of a risk should my husband's plan become unreasonable etc. The two plan idea doesn't seem so bad when my employer's plan is $26/month cost to me. I've got to reflect on this of course, and I appreciate your thoughts on having two plans - it's given me more to consider.

frambuesas

That makes sense, especially as I think all the benefits associated with my husband's plan are better than those offered by my employer's plan. It's just the safety of being on it and not having to worry about a gap that is bothering me, so this could well be a solution. Thank you for your input!

Moonshadow_Girl

I think you're misinterpreting the "change in life circumstance" with regards to your husband's insurance. If your husband were to change jobs, you would lose your health insurance coverage. Period. Most employers that offer health insurance provide for the employee first. Family or dependent coverage is additional and not automatically provided. Your husband is not obligated to add you to the coverage offered at his theoretical new job. Thus, you no longer have health insurance and would be eligible to sign up with your own employer. Granted, you'll have to show that you no longer have health insurance, and sign up for yours most likely within 30 days.

As an aside, a few years ago, I paid a few hundred dollars extra monthly to cover my husband. Eventually, he got a job that offered paid health insurance. Luckily, my (government) job recognized that as a "change in life circumstance" and I was able to remove him from my coverage several months before open enrollment and save us some money.

frambuesas

I may well be misunderstanding - this is all new to me! Thank you.

Pulaski

Are you certain about that detail? My employer only requires that my spouse changes job/ employer to create the "lifetime event".

Agreed.

frambuesas

I asked about it specifically to the insurance specialist at our training class, and she confirmed that if other insurance is available at all through my spouse, I wouldn't be eligible for enrollment until the annual window open to all staff. So I am guessing she would know best!

Pulaski

I'd still research it on your employer's web site, or ask to see the terms and conditions in writing, and not rely on what you were told verbally.

frambuesas

I certainly will do! Thanks.