Can You Have Two Health Insurances? | MetLife (2024)

The short answer to that question is yes, you can have two health insurance plans. In fact, it’s becoming increasingly common for individuals to have more than one health insurance plan. While the majority of people in the U.S. are enrolled in one health plan for a calendar year, there’s a growing percentage of the population with multiple health policies.

According to data from the U.S. Census Bureau, in 2021, approximately 43.1 million people (13.1%) were covered by more than one type of health insurance — up from 12.6% in 2020.1 For the longer answer, and to learn why someone might want dual health coverage, read on.

Why would someone have more than one health insurance plan?

There are several scenarios in which someone may be covered by multiple health insurance plans, including:

  • An individual might supplement their private health insurance plan with a government program, such as Medicaid or Medicare.
  • A married person may have health insurance through their employer and be listed as a dependent under their spouse or partner’s health insurance.
  • A person under the age of 26 may have their own health insurance plan and remain a dependent on their parent’s plan.
  • A child of divorced parents may be listed as a dependent on both of their parent’s health insurance policies.

How do multiple health insurance policies work together?

Having two health insurance policies doesn’t mean you’ll be covered twice by both plans. For example, if you sprain your ankle and go to the doctor, your visit isn’t going to be reimbursed multiple times. Both plans may cover some of the expenses, but the combined benefits won’t surpass the total cost of your visit.

Due to a process called coordination of benefits (COB), one plan will be designated as your primary plan — or primary payer — while the other is your secondary plan. Your primary plan processes the insurance claim first and covers the bill up to its coverage limits. If your primary insurance is unable to cover the entire claim, your secondary insurance may cover all or a portion of the remaining costs. However, you may still be responsible for some cost sharing, such as copays or coinsurance.

Primary and secondary insurance rules

You don’t get to choose which plan is your primary and which is your secondary. COB sets the rules, based on the situation, to help dictate the order of coverage for each insurance plan. Rules may vary by state and insurance provider, but the following scenarios usually apply when determining primary and secondary responsibility.

Scenario

Primary insurance

Secondary insurance

You have your own employer-sponsored health insurance, and you’re a dependent on your spouse or partner’s plan

Your employer-sponsored plan

Your spouse’s employer-sponsored plan

You’re covered under Medicaid and have employer-sponsored health insurance

Your employer-sponsored plan

Medicaid

You’re covered under Medicare and have employer-sponsored health insurance

Your employer (if the company

employs20 or morepeople);

Medicare (if your employer

has fewer than 20 employees)2

Medicare (if your employer

employs 20 or more people);

your employer (if they have

fewer than 20 employees)2

You’re under 26 and have student or employer health coverage, and you’re a dependent on your parent’s plan

Your student or employer plan

Your parent’s plan

Your children are covered

under your health plan

and your spouse or partner’s

health plan

Whichever parent has the

earliest birthday in the

calendar year

Parent with the later birthday

You’re separated or divorced, and your children are covered under both your plan and your former partner's plan

Whichever parent has

custody of the child — if

custody is joint, follow the

birthday rule

The new legal spouse of the

parent with custody or the

parent without custody of the

child

Pros and cons of having two health insurance plans

There are benefits and drawbacks to having two health insurance plans.

Benefits

  • A secondary health insurance plan may be able to cover expenses that your primary plan doesn’t.
  • Your overall out-of-pocket costs may be reduced if the plans complement each other to help limit your individual responsibilities.
  • You may feel a greater sense of security if you were to suddenly become unemployed and lose one insurance plan.

Drawbacks

  • You may have two separate premium and deductible responsibilities, which can add up over time and outweigh the benefits of having multiple insurance plans.
  • Even with two plans, your expenses may not be entirely covered, since the combined coverage can’t exceed 100% of your health costs.
  • The coordination of benefits process can make processing claims more complicated and time consuming.

Consult with your human resources team to learn more about having more than one insurance plan.

Can You Have Two Health Insurances? | MetLife (2024)

FAQs

Can You Have Two Health Insurances? | MetLife? ›

You may have two separate premium and deductible responsibilities, which can add up over time and outweigh the benefits of having multiple insurance plans. Even with two plans, your expenses may not be entirely covered, since the combined coverage can't exceed 100% of your health costs.

Is it OK to have two health insurance policies? ›

Yes, it is possible for someone to have secondary health insurance and perfectly legal, but it is also important to fully understand how primary vs secondary insurance operates.

What happens if an employed patient has coverage under two insurance plans? ›

In there's a claim, the primary health plan pays out first, while the second plan pays some or all of the costs the first plan didn't pay. If you and your spouse or partner both have a health care plan at work, and your children are covered on both plans, the second plan can pay some of the costs the first plan didn't.

How to determine which insurance is primary? ›

To determine which plan is primary, which means the insurer pays for covered services first according to the benefits provided by the plan. The other insurer pays secondary, which means it pays the remaining unpaid balance according to the benefits provided by its plan.

Does secondary insurance cover primary copay? ›

Secondary insurance pays after your primary insurance. Usually, secondary insurance pays some or all of the costs left after the primary insurer has paid (e.g., deductibles, copayments, coinsurances).

Can you have 2 policies with 2 different insurances at the same time? ›

Although no laws prohibit you from purchasing two auto policies from two different companies, an insurer will not allow you to purchase two policies on the same car. If you have an auto accident, filing two claims with two different insurance providers constitutes insurance fraud even with two auto policies.

How is primary and secondary insurance determined? ›

Example: Patient's mother's birthday is October 11, and patient's father's birthday is April 24. In this case, the father's insurance would be the primary insurance and the mother's insurance would be the secondary. If the parents share a birthday, the primary plan would be the plan which has been effective longer.

Which insurance is primary when you have two? ›

Usually, your employer's plan is primary. If you also are covered by your spouse's plan, that plan is usually secondary. There are other rules for many other situations. A special case may come up if you have both medical and dental insurance, and you have a procedure such as oral surgery.

When an individual is covered under two insurance policies? ›

Having two health insurance policies doesn't mean you'll be covered twice by both plans. For example, if you sprain your ankle and go to the doctor, your visit isn't going to be reimbursed multiple times. Both plans may cover some of the expenses, but the combined benefits won't surpass the total cost of your visit.

Which insurance is best for health? ›

List of best health insurance plans in India for 2024
Best health insurance plans in India - 2024Entry age (Min-Max)
Aditya Birla Group Activ Health Plan18 years and above
Niva Bupa Health Plus18-60 years
Bajaj Allianz Health Guard Insurance PlanAge (adults): 18-65 years Age (dependent children): 91 days to 25 years
1 more row

How does double health insurance work? ›

The way it works is that one plan is designated as primary insurance and the other as secondary. A claim goes first to the primary insurance plan, which pays medical bills the way it normally would. It is only after the primary insurer pays the claim that it gets submitted to the secondary plan.

Does it matter which insurance is primary or secondary? ›

Your primary plan initially picks up coverage costs, followed by the secondary plan. You might still owe out-of-pocket costs at the end. Health plans have coordination of benefits, which is a process that decides which plan is primary and which one pays second.

What happens to my younger wife when I go on Medicare? ›

Medicare is individual insurance, so spouses cannot be on the same Medicare plan together. Now, if your spouse is eligible for Medicare, then he or she can get their own Medicare plan.

Should I have a copay with two insurances? ›

Normally patients that come in with 2 insurances should not be charged a copay. In most cases their secondary policy will pick up the copay left from the primary insurance.

What happens if secondary insurance pays more than primary? ›

A credit balance results when the secondary payer allows and pays a higher amount than the primary insurance carrier. This credit balance is not actually an overpayment. The amount contractually adjusted off from the primary insurance carrier was more than needed, based on the secondary insurance carrier's payment.

Can you have medical and private insurance at the same time? ›

Can I Get Medi-Cal if I Have Insurance? If you have private health insurance, you can still qualify for Medi-Cal. Members who already have insurance can add Medi-Cal coverage to their existing plan. Your provider will first bill your private insurance, and then Medi-Cal will pay for any additional services it covers.

When two insurance policies cover the same risk? ›

Concurrent insurance is when two insurance policies are held to cover the same risks over the same time period. Concurrent insurance usually includes a primary policy, with the second policy meant to act as excess coverage.

Which health insurance is the best? ›

Best Health Insurance Companies for 2024
  • Best Overall: Blue Cross Blue Shield.
  • Highest Quality Plans: Kaiser Permanente.
  • Most Health Management Programs: Oscar.
  • Best for Same-Day Care: Aetna CVS Health.

What is the difference between a PPO and a HMO? ›

HMOs don't offer coverage for care from out-of-network healthcare providers. The only exception is for true medical emergencies. With a PPO, you have the flexibility to visit providers outside of your network. However, visiting an out-of-network provider will include a higher fee and a separate deductible.

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