Can you have more than one health insurance? Yes. Many people are covered by more than one health plan. There are rules governing how benefits are determined and they can vary. Fully insured plans are state regulated and follow guidelines set forth by the NAIC (National Association of Insurance Commissioners) to coodinate benefits. The NAIC is a U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from all 50 states.
- 1 Can you have more than one health insurance?
- 2 How do I choose the best health insurance policy?
Can you have more than one health insurance?
Coordination of Benefits (or COB) generally requires that the insurance carrier that covers the claimant as its main subscriber (not as a dependent) acts as the primary payer. The primary payer issues its ordinary benefits, same as if no other insurance applies.
The claim is then submitted to the claimant’s secondary insurance carrier, which also determines its ordinary benefits, but deducts the amount already paid by the first carrier from its remittance. Often, the result is nothing left for the claimant to pay out-of-pocket. However, this is not always the case. Charges that are not covered by either carrier, unmet deductibles, and other factors can affect claims payments.
The health plans of self-insured employers and unions are not state regulated. They typically do coordinate benefits, but are free to follow their own rules. They may or may not remit the same level of benefits as a secondary payer that an insurance carrier acting in that role would be obligated to pay.
Say for example a person has 5 lac policy from Insurer “A” and another 5 lac policy from Insurer “B”. Suppose there is an expense of 8 lac which is payable as per policy condition. In such a scenario, one can claim first from Insurance company “A”.Once one gets reimbursed then can collect the attested photocopy of the bills from insurer “A” as well as claim note from insurer “A” and submit the same to insurer “B”. Insurer “B” will then make the balance payment.
Benefits of Getting Multiple Health Insurance Plans:
There are many edges of getting multiple health insurance policies as mentioned herewith:
Personal Health Policy and Critical Illness Plan
Fixed health insurance benefit plans, or critical illness plans, provides protection additionally to the regular personal health insurance policy. Generally, high expense diseases or critical illnesses are not lined within the general health care plan. An individual can thus take pleasure in buying critical illness plan set up additionally to personal health policy and maximize coverage by minimizing risk.
Rejection of Health Insurance Claims
In things wherever claims get rejected by the health insurance provider, it may be a disaster for the family, paying for large medical expenses from the pocket. Here, multiple policies have tremendous edges. If a health insurance claim is rejected by one health insurance company, it may be accepted by another, and thus, the whole claim cash isn’t lost. Thus, having multiple insurance policies act as a hedge against claim rejections.
Diversify across Insurers
Individuals should purchase multiple insurance plans from a totally different health insurance provider. This is a great way to diversify across insurers and take pleasure in their coverage policies. Moreover, claims are settled as per the contribution clause, once the claim is beyond the total insured for one policy. If the total insured is bigger than the claim quantity, the individual will file a claim with either of the insurance companies. For pre-existing unwellness, each the insurance service suppliers can build payments as per their norms.
Instead of finance in one set up with huge coverage, you’ll purchase multiple health policies. this may eventually add up to an enormous cover, and you’re probably to pay lower health insurance premium amounts as compared to purchasing one set up with larger health coverage. Smaller covers from multiple health plans add up to an even bigger coverage and conjointly prove to be more cost-effective.
When an individual buys multiple health insurance plans with smaller covers, it tends to lower premium amounts significantly as compared to finance in an exceedingly single policy with larger coverage. At the same time, smaller covers from multiple plans conjointly add up to greater coverage, as mentioned on top of, while not excavation a hole into your pocket.
How do I choose the best health insurance policy?
It would be advisable to identify your needs first and compare the features of various plans offered by the insurance companies.
Then only you can choose the one that fits your specific needs. During this process, there are a few key points to consider:
1. Is there any co-payment in the policy
Opt for a policy that comes with a no co-payment clause or has a lower % of co-payment
2. Cashless network – The most crucial aspect.
The larger the network, the better it is. Also, be sure to check whether the best hospitals in your locality are covered in the cashless hospitalisation network of the insurance company to choose
3. What is the waiting period
Most policies have a waiting period ranging from 2 to 4 years for pre-existing illness. The key is to choose a policy that offers lower waiting period
4. How much NCB gets added each year
This is crucial as medical costs are rising at a rapid rate each year, a good % increase in NCB is one of the ways to ensure that you are adequately covered. However, bear in mind that the NCB reduces with each claim
5. Are day-care treatments covered
Due to medical advancements, many illnesses are now treated without hospitalization beyond 24 hrs. Thus, it is important to know whether your policy covers these treatments and also how many such treatments are covered