Is Secondary Insurance Worth It? A Guide to Having Two Health Plans

Posted on January 29, 2021

It’s that time of year where effective dates are creeping up.

The pharmacist calls are overwhelming and you can't book a doctor's appointment.
These days, insurance can be especially complex to unpack.

With so many details, the language itself is tricky to decipher. In the past, we may have purchased insurance policies without an authentic reflection of what those plans entail.

And today, it is difficult to feel confident in your insurance policy coverage. Is secondary insurance worth it?

Enter deductibles, out-of-pocket maximums, and prior authorizations. Zooming into the details of your insurance policy can be exhausting without guidance. For many folks, supplemental insurance is a new concept.

And many more may even ask, "can you have two health insurances?"

The great news is that you're in luck. Secondary insurance policies have been around for a long time, and they're not going anywhere anytime soon. Working with a secondary insurance policy means you have preventative measures and then some protecting your health.

There is such a thing as primary and secondary insurance. Both are legitimate and can actually be very beneficial to their insurers. Let's talk about the pros and cons of each.

What is Secondary Insurance?

Some folks find themselves in a position where they end up having two health insurance policies.

This is a beneficial intersection as it means that there's a marginal chance that you'll save some money in the long run. It's crucial to discuss health insurance plans with your family members or spouse. This helps you check out insurance plans that cover everyone's medical needs.

If you're someone who does not have regular doctor's visits or medication maintenance needs, you may be better off with a primary insurer.

Here are a few scenarios in which you may have two health insurance plans:

  • You may be 26 years old or younger with employer coverage and coverage through your parent's plan
  • You are married and have individual insurance policies
  • You may be 26 years old or younger with parents who have separate policies that can both claim you as the dependent
  • You may be 26 years old or younger and married, receiving coverage from your spouse and your parents. 

Folks with dual insurance plans are fortunate.

If you're utilizing a secondary insurance plan, it means that your plans combined will never exceed 100% of the cost of services rendered. Primary insurance takes effect first. It is aimed to cover the services listed specific to your individualized plan.

Secondary insurance will, in the best-case scenario, pick up a remainder of those costs.

It’s possible that you would owe the cost of uncovered services rendered. For example, if you had co-insurance at 40%/60%.

Your primary insurance will provide coverage first to make sure that part of the bill is paid. The rest of the bill will be sent to your secondary insurance policy.

Is Secondary Insurance Worth It?

Having multiple insurance policies means there is a need to meet the premiums and costs associated with your policy coverage.

For example, if you choose to connect with a provider who is outside of your policy network, your primary insurance will not cover those services. Your secondary insurance will also default to no coverage since your primary didn’t cover.

There are many positive aspects to having a primary and secondary insurance policy. If you’re fortunate enough to have insurance coverage through your parents or your significant other's plan, your needs are in a great spot, and you won’t have to stress about losing coverage.

Accessibility is a huge part of having primary and secondary coverage.

If you have access to two plans, you can maximize your coverage and save the money you're getting coverage for cheaper than you would pay for an inhaler out of pocket. Insurance carriers will work together to create a path that enables your benefits to complement one another.

Health insurance providers and healthcare providers decipher which of the plans would be regarded as the primary plan. Once they determine which plan is which, the main brunt of that coverage is provided through the primary plan.

In this approach, the primary plan will pay the expected cost in short of having a secondary insurance plan. There could still be medical costs owed at the end of the day depending on what the insurance provider considers is reasonable or customary.

The language behind "reasonable and customary" refer to best practices and common application of insurance coverage insurance providers. 

These terms are at play to respect that everyone's situation is very different in regards to their health. And everyone is entitled to, and deserves access to getting their medical needs met.

Can We Claim Insurance From Two Companies?

In the worst-case scenario where the unimaginable happens, you want to know that you and your family members are protected. There is perhaps no other better case scenario to have dual insurance policies and then in the case of a catastrophe.

If there is a major illness diagnosis or an enormous claim due to an unforeseen surgery, your benefits will kick in and your secondary insurance could step up and absolve you of further charges. 

Two health insurance plans can also prevent a person who is about to be unemployed from living without health insurance benefits. And with the rate of unemployment and lack of health insurance support, this is something very important to consider.

When exploring supplemental insurance policies, an indemnity plan differs from a non-indemnity plan. An indemnity health insurance plan gives you the autonomy to choose your own doctor.

This is especially helpful if you feel like you don’t want to commit to one specific primary care physician. You may bounce between a few that may not be in-network with your insurance policy.

Your indemnity plan will be flexible and curated by your hand. Indemnity insurance plans will have a set standard for the cost of services rendered. They can also empower you to self-refer and will not require a referral from a provider to be compensated.

Having a non-indemnity insurance plan is going to provide coverage for situations with no replacement value. For example, no one can be compensated to replace the cost of someone’s life.

If these options sound like they may fit your needs, you can explore them in greater depth to decide what details are applicable to your situation.

Risk Factors

Between genetic pre-dispositions and environmental factors, some of us are living at a higher health risk than others.

Sometimes it's due to the nature of your employment, or maybe the fact that high cholesterol has run in your family for generations.

No matter the case, higher health risk factors can put you in a dangerous position. If you're aware that your kids are approaching a scenario where they're going to need dental support, this may be the perfect time to consider a supplemental plan.

Similarly, if you're in a situation where your spouse is in need of a long-term care facility, it may be in everyone's best interest to have a supplemental health plan that can shoulder the associated expenses.

There are other risk factors that can contribute to your health insurance premium. Premiums for those who are elderly could be triple the amount that another person at a younger age would pay.

Your geographic location can have a big effect on what you’re paying monthly, as the area you live in may come with its own set of risk factors.

For example, if you live in a highly-populated area in Toronto, Ontario with high air pollution, the premiums could look a little more expensive than a place like Prince Edward Island.

Tobacco use will also influence your monthly premium.

In times of crisis, you do not want to be considering whether or not you can afford the health care costs for yourself, or your loved ones.

Having the confidence of a supplemental health insurance policy can help you rest easy, recognizing that even though you've had to weather some tough experiences, your health coverage is something you can rely on.

Affordability and Practicality

We know the value of a dollar better today than we ever have.  With kids, colleges, universities and mortgages, saving a few dollars here and there really adds up over time.

Secondary health insurance is often very affordable. And while the meaning of affordable varies between people, we'd like to think that products starting around $80/month is reasonable.

If you have been afforded two health insurance plans, then enjoy the freedoms and access it provides. If you're someone who is searching for a supplemental plan without breaking the bank, don't worry.

You can find a plan that supports your cost of living, all while having good coverage and the ability to save a little money in the long run.

Do Your Research

Searching for a supplemental health insurance plan is simple, especially when you use one of Canada's top brokers like Insurdinary.

It might help to jot down some bullet points about what your main concerns and needs may be. This way, when you connect with an agent to discuss your expectations, you are both speaking the same language.

At the end of this journey, you are going to feel uplifted by the level of healthcare support you've built for yourself and your loved ones.

You Deserve Protection

You may need time to determine whether to opt for a secondary health insurance plan. Consider the plethora of options afforded to you by those policies.

You might be searching for the autonomy that specific plans can provide. Or you might be searching for a narrow, detailed plan curated for you.

Insurdinary is a broker for all of the major insurance company's across the nation.   We are able to provide the best possible quotes for your supplemental insurance needs.   Contact us today!   We look forward to working with you.

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