My daughter is graduating and May, and has a job! Woo Hoo! She will be many states away from us. Currently, she’s on our insurance, along with her younger brother. The premium is the same for one child or two, so we might as well keep her on our Anthem HMO plan. However, in school she’s had some problems finding in-network providers, even though we have the “guest membership” for Anthem in her college town. She has ended up scheduling all appointments during visits home.
With her new job, she’ll be able to get her own insurance with a $1500 deductible, $44/month premium, and the employer matches HSA contributions. I figure that’s $1700 from the company per year, if she saves her half of the max $3400 contribution, which could give her a nice cushion later in life.
Is she allowed to stay on our insurance to age 26 even with her own insurance? I know some plans do not allow for spousal coverage if the spouse has insurance available at work.
I think it is time for her to move on - take her off your insurance, have her get her own insurance, and have her establish care providers where she lives (Primary care, OB/GYN, dentist, eye doctor, etc.)
Most plans would let her stay on until 26 - when you are covered under two plans - one plan has to be the “primary” and you would end up with hers being primary since her doctors would be “in-network” on her plan.
I’d check with your family plan. HR should have written info about coordination of benefits for dual coverage. It can be useful, especially if it expands the pool of providers she can see. Generally the coverage from an individual’s employer is primary and the other is secondary.
Our plan allowed our S to stay with our family plan whether or not he had his own job and his own plan with his job. He chose not to get insurance until he aged out at 26 and saved the money he would have fax to pay towards premiums.
Our insurer admitted our plan was as good or better than anything S could get. It’s a PPO with BCBS that would allow him care with any in network provider in the US. He did get a lot of care when he came gone for the holidays but can also get care where he lives or is traveling.
She should also check with her employer but I see no disadvantage of her remaining on your policy and also getting one from her job.
The disadvantage is the coordination of benefits. One insurer will be primary and she’d have to follow that insurance for in network coverage, etc. If they then submit for anything uncovered to be paid by insurer #2, and of course that coverage might be OON and have a different deductible.
At a minimum, it makes sense to ask the HR or family plan insurer about coordination of benefits and also whether she can be dually enrolled with both family plan and her employer as well as HR and/or insurer at employer.
My experience with dual enrollment has been great and often between the dual coverage, insured pays little to $0! It’s just the insurers hassle for gen to sort out–not Insured’s headache. They do this all the time.
Why give up something that costs nothing and gives you more treatment options? Simpler is NOT always better. Giving a person more treatment options is better, in our experience.
Especially in these times you/she have no idea what her job health ins premiums might be next year or if she’ll even still have that job. She should definitely take their ins, it’s a net gain, but keep her on yours, it’s zero cost. Dual coverage is great and often results in completely “free” health care.
We just went through this with two recent grads, and it can be confusing. We definitely had to talk to both insurance companies and/or employers to find out more info, and were sometimes still confused and misinformed. It’s my understanding that a person is not eligible for a Health Savings Account (HSA) under IRS rules (see IRS Pub. 969) if the person has any additional coverage other than the high deductible plan. The person with other coverage can still select the high deductible insurance plan, but cannot contribute to an HSA or receive the employer matching contribution to the HSA. If the plans have networks with a lot of overlap, it might be possible to find doctors who are in both plans. In that case, the secondary insurance (the parent’s family plan) might cover the costs that are attributed to the deductible by the primary plan (the new grad’s employer coverage.) Whether all this is beneficial will depend a lot on the networks, the deductibles and out of pocket limits, and the costs of the two insurance plans.
These issues terrify me in the current political climate. For those of us who have kids with expensive chronic illnesses, it is hard to sleep at night.
We just try to keep ourselves and loved ones covered as best we can with no lapses or gaps in coverage and do our best to sleep.
It is always a good thing to have options. One can always elect to go off the family plan but might have a tougher time getting added back on, depending on insurer and plan. There is generally an open season every year as well when the insured can change or add coverage. I believe you can drop coverage at any time with insurance plans.
Good point about the HSA, bears looking into. Your D may be eligible, as a substitute, for an HRA, very similar EXCEPT not portable & the “Insured” cannot contribute. I have personal experience with both HRA and dual insurance.
For $44/month, if it were my kid, I’d say go for it, even without HSA or matching. There may be additional perks such as gift cards, a free eye exam or discounts on contacts, maybe one or the other plan covers something like dental that the other doesn’t, etc.
In general, with dual plans, each plan will pay what they would have if they were the only plan, but total reimbursement cannot be more than total charges or perhaps total “allowable” charges as each plan sees it. Dual plans is a cushion against accidentally going out of network.
One or the other plan may also have free or reduced gym membership or additional benefits. I have never met anyone who wished they had LESS medical insurance!
Like you, we paid nothing extra to keep oldest on the family plan. Even having me on H’s plan requires “family” coverage, so me, me+one kid, or me+both kids…same cost to us!
The plan through your child’s employer is likely to be primary (your insurance tells you who is primary, you don’t get to pick), but the other one picks up. D had surgery and paid less than $200 OOP. Sometimes there are little hassles. For us, it’s been a matter of a certain hospital trying to bill us according to whatever plan allows them to send us the biggest bill. Keep your EOBs and very firmly do the math for them.
Another place double coverage can really help is with prescription drugs. In our case, d’s employer’s plan covers 100% of generics but only 50% of brand name. All her generics run through her employer plan, but she runs the brand name one through the fam plan. This has been terribly difficult for Walgreens to figure out. Another small headache, but it saved a few hundred a month in drug costs.
I think for $44 a month, the d’s own insurance is well worth it, especially since the fam coverage is an our of area HMO. Wouldn’t drop the fam coverage because it costs you nothing.
Yes, when I was taking a very expensive medication, it was great that I had dual coverage–from my employer and H’s. It kept my OOP cost at $0, otherwise it would be several hundred every month!