Dual Insurance Coverage

[reeser1977]

What is the name of your state (only U.S. law)? Texas
My father recently retired. They have insurance through Teacher Retirement System of Texas. He has gone to work for Lowes and is considering taking their insurance to have dual coverage. In the past we were under the impression that one company would pay a percentage and the other company would pick up the other percentage. However, he was told that some people have had the experience that whichever one pays first the othe refuses to pay the other part. Can you tell me what the laws are if any and if it would do any good to have dual coverage? Thank you for all your help?

[momm2500]

you have to look at the plan wording on how coordination of benefits works. first if he takes the medical plan with Lowes, that would be his primary plan and the retiree plan would be second. you need to see what that plan states before you can assume how they would handle bills.

[cbg]

To give you a very general rule of thumb, unless the benefits in the secondary policy (and the above poster is correct about which is primary and which is secondary) are considerably better than those in the primary policy, it is usually not cost effective to carry both coverages. In most cases, the secondary policy will only pay the difference between what the primary carrier paid, and what the secondary policy would have paid had they been primary. (Example: Bill is for $100; primary policy paid $80, secondary policy would have paid $85 had they been primary; secondary policy pays $5, patient pays $15)

But I agree that he would have to look at the exact wording of the two plans in question to be sure if it would make sense for him. What I've described is common, but it's not a guarantee.

[reeser1977]

Thank you both.