OT: Health Insurance

Read the fine print. It's likely that ALL your carriers have fine print that disallows multiple payouts for the same claim. How they find out, if you don't tell them, is unclear. What they do when they DO find out is likely spelled out in the fine print.

I have a friend who has two policies. They coordinate and the second one picks up the stuff the first one won't pay.

There's no reason that a company would elect to pay for the health insurance of someone who is already insured.

ovider which basically inquires whether I have other insurance.

presumably with their competitors since wouldn't they know if I had additio nal policies through them)?

ur claims will be paid late and/or not at all if you don't fork over this i nfo. They claim it is a Business-As-Usual annual review and company policy , blah, blah, blah, and that one of the "many benefits" may include less ou t-of-pocket expense for you. (Yeah right, when pigs fly?)

son they can think of. I understand that some folks will have Medicare and supplemental insurance and there's a legitimate need to know which policie s cover what. But this obvious vying for subordination of primary payment responsibility kinda pisses me off. It's a real shame the questionnaire is n't printed on softer paper!!

damn questionnaires I'd like to get the facts. Google was useless. Oh, a nd of course, the topic should certainly appeal to all the old fart, far-ri ght wingers and privacy advocates lurking here on SED... :)

It depends on the specific risks the first insurer covered. There nothing s topping you from getting cover from a second insurer for a risk that you ma in insurer declines to cover.

Yes. If you have dual insurance, which is not all that uncommon when spouses each have insurance that is fully paid by the employer, the two insurance companies don't want to both pay the same claim from the provider.

That is not the reason. It is to avoid two insurance companies paying for the same claim.

It is probably less common now that employee contributions to health care plans are much higher than in the past, but there are probably still employers with 100% paid health care where both spouses take the coverage.

In that case, the insurance companies don't seem to mind accepting the premiums for both plans even though only one of them is going to pay out. Are we really supposed to believe this is baked into the rates?

vider which basically inquires whether I have other insurance.

resumably with their competitors since wouldn't they know if I had addition al policies through them)?

r claims will be paid late and/or not at all if you don't fork over this in fo. They claim it is a Business-As-Usual annual review and company policy, blah, blah, blah, and that one of the "many benefits" may include less out

-of-pocket expense for you. (Yeah right, when pigs fly?)

on they can think of. I understand that some folks will have Medicare and supplemental insurance and there's a legitimate need to know which policies cover what. But this obvious vying for subordination of primary payment r esponsibility kinda pisses me off. It's a real shame the questionnaire isn 't printed on softer paper!!

damn questionnaires I'd like to get the facts. Google was useless. Oh, an d of course, the topic should certainly appeal to all the old fart, far-rig ht wingers and privacy advocates lurking here on SED... :)

They will deny benefits if you do not return survey.

"Q: What is Coordination of Benefits (COB)?A: COB usually applies when you or a covered dependent are covered by multiple health plans at the sametime . For example, you and your spouse have coverage through each others employ ers; you each coveryourself and/or dependents. The provision is designed so that the payments by all plans do not exceed 100percent of billed charges for the covered services. The provision also designates the order in which themultiple health plans are to pay benefits. Under a COB provision, one pl an is determined to be primary andits benefits are applied to the claim fir st. The unpaid balance is usually paid by the secondary plan to the limitof its responsibility. Benefits are thus "coordinated" among all of the healt h plans. "

Most important: " Often, we may need to suspend the payment of your medical claim until we receive your COBquestionnaire response, so it's important to make sure you respond."

There is no "may" to it.

When a company insures an employee under a group plan, they pay a fixed fee per month, whether there are claims or not. And a provider will bill one insurance company, not two, and gets paid only once. Double coverage wastes premium payments.

My company discourages people from being insured twice, like for instance if their spouse's employer will already cover them for free.

If both companies (employers of husband and wife, or equivalent) offer such plans, some people will take both, for whatever reasons. Most companies try to discourage that.

Since insurers are competitors, everything is baked into the rates.

I think your question is being mis-understood. What do you mean by "company".

Do you mean you got a questionaare from the company you work for i.e. your employer, or do you mean from the health insurance company?

Mark

Google "coordination of benefits". This can actually work *to* your favor assuming you are covered under two plans -- e.g, yours (as primary) and your spouse's (as secondary). I.e., a claim that *you* make will FIRST be processed by YOUR carrier. The *balance* (NOT the entire original claim) will then be addressed under your spouse's plan.

As to whether or not you MUST reply: I suspect the fine print of your plan document says that you must. And, omitting "pertinent data" is probably grounds for them to deny coverage or even revoke your plan.

Asked another way, what do you hope to *gain* by not replying truthfully?

The TROLL RETARD, FRED BLOGGS is NO expert of ANYTHING, much less what the American health care system operates like.

The "guess as you go" retard actually thinks he has a life, when he gets on Usenet and spews his horseshit.

Do not give any credence to anything this NON-resident says about the subject. No credence for anything else the putz states either.

OP has BCBS, I quoted from the BCBS FAQ. BCBS will zero out payment to his medical services provider, the medical services provider will then send the OP a bill. Of course his deductible is so idiotically high, this will only happen under catastrophic circumstance, possibly push him over the edge an d make him stroke out.

Yes. I had a trip (or three) to the ER recently. My insurance company wanted to know all about other insurance (was it an accident, could we pass it off on someone else? - No)

They want to know if there is someone else to share the cost with.

It is perfectly normal. They do have a right to this information.

Nope. They don't want to pay for what someone else should be paying for.

Health insurance company. I am a member (i.e., owner) of the LLC involved - the one that is paying the premiums.

Understood. I'm just not "convinced" they really have a right to this information.

May not be the perfect analogy, but let's assume I'm addicted to gambling a nd I bet on the same horse from two different bookies. The horse wins. Th is is like the first bookie demanding to know if I have any other bookies s o he can avoid paying out the entire winnings.

Substitute healthcare policy for the bet placed, insurance company for book ie, accident for win place or show, and hospital payment for winnings.

and I bet on the same horse from two different bookies. The horse wins. This is like the first bookie demanding to know if I have any other bookies so he can avoid paying out the entire winnings.

okie, accident for win place or show, and hospital payment for winnings.

Bad analogy. When you bet, the size of your winnings is proportional to the bet placed.

When you get injured or sick, the hospital costs are determined by the inju ry or the disease. How much of those costs are covered may be determined by the size of the premium you elected to pay, but the costs themselves are q uite independent of the premium.

That's irrelevant. "Mutual" insurance companies are no more your property than a credit union is. The insurance company c/would still send the letter if an employer were self-insured.

You're wrong, but somewhat understandable.

You can't "profit" from insurance. In the horse race scenario, you have no control over the outcome. You could tilt the odds on insurance for yourself.

The analogy doesn't hold. Insurance isn't a "bet" in the classical sense. It's also a matter of contract law. The policy terms (which you accepted) disallow multiple payouts. They will have "primary insured" or coinsurance clauses.