NatashaB

How does coordination of benefits work? If my stepdaughter is included on both my husband's and her mother's policies, is it as simple as her mother's insurance paying the allowed amounts under that policy (her mother's birthday comes first in the year, which I understand is the usual way of determining the primary policy) and my husband's insurance picking up the co-pays/deductibles? Or is it more complex than that - will there be 2 sets of out of pocket costs to be met? Are there any pitfalls to doing this?

Pulaski

Including her on two policies will mean paying for her twice, so why would you want to do that? .... and you'll likely an argument every time there is a claim. At least once a year I get a form from my insurer requiring that I certify that my daughter is not covered under any other policy. What I am fairly certain about is that you cannot claim on one policy and then claim the OoP copays and deductibles on the other.

NatashaB

OK, thanks. I thought it wouldn't be that simple . Unfortunately her mother probably wouldn't want to give us the details of her policy, so I guess we'd need to cover her under our own for that reason in case she needed to be admitted into hospital whilst staying with us. Is that likely to leave us any worse off than if she was only under the one policy?

Pulaski

Well your situation is far from unique. I think the first, and most sensible thing to do is ask for the girl's mother to obtain a duplicate insurance card with the girl's name on it. You should certainly avoid paying for duplicate insurance because (i) it will be ridiculously expensive for the likelihood of it being needed, and (ii) it will create a tangled web of legal and practical problems, because if you take her to her usual doctor they are going to over-write her "usual insurance" with the coverage arranged by your husband. The process of claiming and reimbursing medical expenses is already incredibly complex and fraught with the risk of error. Adding a duplicate, and unnecessary, insurance policy to the mix is to be avoided if at all possible.

NatashaB

Thanks. Technically this won't be an issue until open enrollment but I know it's going to be a headache to agree something sensible!

scrubbedexpat097

One will be a primary insurance and one a secondary. If her mothers is the primary then you would have to file that first and use her dads as the secondary. That would mean having to have the details of her insurance...and that sounds like that is what you were trying to avoid

Hope youcan sort it out without too much hassle

kins

What if you offered to pay half the premium? Then you'd all be better off...

md95065

When more than one insurance company is involved each one will claim that one of the others should pay out first ...

NatashaB

That would be a sensible idea. Unfortunately I doubt we'd get an accurate estimate of what half of that premium actually was

Thanks, everyone. At least I know it won't be as simple as keeping her on both policies and having one pick up the copays etc. Always better to be prepared...