I have 2 health insurance policies. How is it decided which one is responsible for covering a claim?

Posted on February 8th, 2010 by admin


Depends on who the subscriber is on each and if they will coordinate benefits with another policy and how they will coordinate benefits or just pay independently of any other policy.

If a spouse is the main subscriber and you also have your own coverage, yours will be primary and your spouse will be secondary. However, you will have to look at the coordination of benefits clause in the secondary policy to see how it will pay any balance after the primary pays. Most times a secondary policy will only pay up to what they would have paid if primary-so if the primary pays 80 percent and the secondary would have paid 80 percent as primary, the secondary will not pay any additional benefit. that is why it usually doesn’t pay to have 2 insurance policies unless one offers coverage for a benefit that the other does not.

5 Responses

  1. SDD Says:

    They will coordinate benefits, so the one with the "better" coverage will end up paying more. why would you want to pay for redundant coverage, anyway — either directly or indirectly through employers?
    References :

  2. bud68 Says:

    One will be deemed primary payer and the other secondary payer. It depends on how you qualify for each coverage.
    References :

  3. madjackolantern Says:

    the one that was issued first is the primary carrier.
    References :
    insurance insider for 25 years

  4. Daniel R Says:

    The better one will end up with more coverage and the other one will with less. And it need more details to come up with an exact to your question like the premiums amount you are paying for each health insurance policy.

    http://www.rghins.com/
    References :

  5. Lori S Says:

    Depends on who the subscriber is on each and if they will coordinate benefits with another policy and how they will coordinate benefits or just pay independently of any other policy.

    If a spouse is the main subscriber and you also have your own coverage, yours will be primary and your spouse will be secondary. However, you will have to look at the coordination of benefits clause in the secondary policy to see how it will pay any balance after the primary pays. Most times a secondary policy will only pay up to what they would have paid if primary-so if the primary pays 80 percent and the secondary would have paid 80 percent as primary, the secondary will not pay any additional benefit. that is why it usually doesn’t pay to have 2 insurance policies unless one offers coverage for a benefit that the other does not.

    References :

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