My question is can a spouse have insurance coverage through his employer and be added to my companies plan as well? That would mean that he has coverage through his own company and through mine, giving him dual coverage.


Answer

Typically a person would only need one policy that counts as minimum essential coverage under ObamaCare, but can have more than one if they choose.

In fact, there are a few scenarios in which it makes sense to have "dual health insurance coverage."

For example, when a family has two very good employer plans due to both spouses working, when a person has access to both Medicaid and Medicare, or when it makes financial sense to pair an existing individual/family or employer policy with a new individual/family or employer policy (this would have to be a very specific case to make sense).

With private plans, the plan with the oldest policyholder birth date is designated the “primary plan”, while the other is designated the “secondary” plan. With Medicare and Medicaid, Medicare is the primary payer for most services, and Medicaid covers benefits not offered by Medicare.

Generally, the insurers will coordinate benefits, so it makes it simple on the policy holder's part.

Claims can be submitted to both policies, and this allows the plan holder to take advantage of the policy offering the best deal.

That being said, this setup only makes sense in specific cases (such as when at least one plan is subsidized by an employer or the state).

The reason this is true is because all plans are subject to the same out-of-pocket maximums, and thus there is only so much you can spend with any one plan in-network (and in some cases out-of-network). Also, every plan is subject to deductibles, thus you have to spend down a certain amount on a given plan before its full range of cost-sharing benefits kick in.

Given the above, it would rarely make sense to hold two high deductible plans, but would make sense to hold two employer subsidized low-deductible plans with lots of differing benefits (especially true since employers can essentially penalize you for not taking their plan).

In short every situation is different, but the bottom line is having two plans is an option that makes sense in some situations, but you only need one.

If you choose one plan, you should generally aim to pick the one with the best coverage that you think you will keep for a full policy period. In cases where you have dual coverage, the insurer will do most of the work.

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A Patel on

I don’t like answer make more confused

ObamaCareFacts.com on

In short no person should ever really have more than one health plan. It would almost never make sense. But if you feel you want to then the answer gets a little confusing because there is a lot to consider.

Dennis on


Answer Rating:

Currently I have tricare prime for retirees but it is limited in several categories which my current employers insurance provides. In this case, could I have dual coverage since there is a 12 month reenrollment period for tricare and I would like to keep it in case I am laid off.

ObamaCareFacts.com on

This is one of those cases where it could make sense to retain two types of coverage despite a lack of immediate benefits. Unless there is fine print with TRICARE this shouldn’t be a problem.

Fernando on

What about if I want coverage in two different states like Texas and Florida?

ObamaCareFacts.com on

You can’t get two cost assistance’s, but an insurer will happily sell you another plan. This is bad form in most cases. Better to go with a multi-state PPO.

Diane West on

I’m confused. If I have a family blue cross blue shield healthplan from the government, do I still require health insurance from my place of employment? The blue cross is a much better plan than my employers. And if I don’t take my employers, will anybody be penalized?

Richard Bean on

How would this apply to someone is under 26, working, and enrolled in a group health insurance through their employer? That person is still eligible for health insurance coverage under their parents’ family health insurance until they turn 26. The parents are paying the same insurance rate no matter what, so why wouldn’t that offspring under 26 still claim under the parents’ policy as supplemental coverage?

ObamaCareFacts.com on

Most plans will charge additional money for the sub-26 dependent. Even if the parents aren’t paying, someone is. Same thing with the employer plan. If a person is getting two for all intents and purposes “free plans” and neither plan stipulates the person can’t have other coverage, then in this case I guess it is a personal choice. I’m trying to think of how this could be though, and not 100% sure I get it.

t on

I know many people who have had two insurance plans and this has always proven useful. There are many circumstances when this can occur.

Marc A Smith-Brown on

my wife has medicare under Obamacare can he have more than two policies at once if the two plans sh has don’t cover the care she needs

Savannah Robin on

We purchased health insurance through the marketplace. We want to add our son to our plan, but he is currently covered under his mother’s husband’s plan (his step-father). We have called the Marketplace help line and were told he cannot be covered by 2 plans. Can you please explain why?

ObamaCareFacts.com on

Can you have Medicaid and work-based insurance… hmm. The best one to ask would be your state Medicaid department, I would guess the answer is no but i’m actually not 100% sure.

Debra Klausner on

I have Medicare, but not using. I have private health insurance from my employer, next year I will retire and only have Medicare.
What does Obama care provide for part b?

Jodie on

I currently am on my parents insurance and have been for a while. But I will be getting married in October and turning 26 in January so I figured I would just bite the bullet and get on my employers health insurance. As of September 01, my insurance will my employer kicked in, but I am also still on my parents insurance. I have a Drs appointment today and have not notified them of my insurance situation. Am I still able to go there using the insurance that I am on with my parents? Since that Dr does not accept my new insurance plan.

ObamaCareFacts.com on

You can use any plan currently covering you up until the day you lose coverage. So in the situation you describe you are fine using the plan you have until that is cancelled and the new one starts.

Alice on

If my new employer offers a fully paid health insurance plan for an employee with a $1000 addition to my HSA and my husband’s employer offers us a family plan as our almost 26 year old daughter is still on it, is it fair for just me to be on both insurances. My husband’s plan is an HMO which is better coverage than my employers, but $1000 from my employer would pay the addition of me on my husband’s. If I waive my employers insurance Is said that I understand enrollment in the future may be restricted because of the waiver.

erin.georgen@gmail.com Erin on

It is absolutely fair for just you to be covered under to employer plans. Or you to be just covered by your employer’s plan and your husband and daughter to stay on a family plan under his employer. There are restrictions, however, and you can’t use HSA funds for premium costs for family coverage through your husband’s employer. That being said, you can use the funds for the out-of-pocket costs for yourself and ALL your qualifying dependents even though they are covered under a different insurance plan. To get the most tax benefit from your HSA, you should contribute your families expected out-of-pocket medical costs to your HSA and use it to pay costs, but only up to the individual contribution limit for the year ($3,400 for 2017).

Maria on

If a patient enrolls with two Obamacare plans, one is through the spouse and the other is through herself, both effective at the time of service, both paid on the claim. Which plan should be considered primary?

erin.georgen@gmail.com Erin on

Obamacare is not a health plan. It is a law that regulates private insurers. If you are trying to say that one person is getting coverage from 2 different marketplace plans and that are both getting cost assistance, they patient may (intentionally or unintentionally) actually be breaking the law and may be required to pay cost assistance back or be denied coverage under one of the plans. Keep in mind that all the insurers sell the exact same plans outside of the Marketplaces as they do on the marketplace, but only those enrolled through the marketplace can get cost assistance.

Legally people can buy as many private plans as they want, but a person can only receive cost assistance through the marketplace on one healthcare plan.

Jon on

I am curious about this situation in the event of a long term event. I have met several people who have lost their jobs in the process of dealing with a personal healthcare event. Consequently, when they lose their job, they lose their insurance,and because they cannot afford the COBRA premiums left to them when they lose their income they are left with going to the local county hospital, which is not always the best care. If I have insurance and place my spouse under my employment subsidized plan, and my spouse does the same, can we cover each other in the event one of us loses our job?

Emily on

I am currently covered under my spouse employer plan. However, this plans specifically EXCLUDES coverage for bariatric surgery. I am looking to enroll in a plan in the marketplace that will cover the surgery. Will I have to cover both plan deductibles before any coverage kicks in? Or does the fact that the employer sponsored plan excludes it, exempts me from having to pay both?

Emily on

I am covered under my spouse employer sponsored plan. However, I am looking into getting bariatric surgery and they specifically EXCLUDE it from the policy. I’ve heard that when you have two plans you must pay for both deductibles before any plan pays anything. So the questions are: (1) Is this true? (2) If I purchase/obtain a second plan in the marketplace which would cover the procedure, would I have to pay both plan deductibles before coverage kicks in? (3) Or would the fact that the employer sponsored plan specifically excludes it, exempt me from having to pay both?

Kate on

Ok I have a tricky one I have a group policy that I have through work that I pay little for…I am looking into doing some infertility treatments that are not covered under my insurance company due to me working for a catholic organization, but I work in Illinois and they have mandated infertility treatment coverage. Can I sign up for an individual plan as a secondary insurance that is not my spouses employer because it covers the needed treatments?

Kate on

Ok I have a tricky one I have a group policy that I have through work that I pay little for…I am looking into doing some infertility treatments that are not covered under my insurance company due to me working for a catholic organization, but I work in Illinois and they have mandated infertility treatment coverage. Can I sign up for an individual plan as a secondary insurance that is not my spouses employer because it covers the needed treatments?

Jeff Sebring on

Thanks!

Catherine on

I am actually wondering the same thing. I am looking to purchase a policy through the health exchange so i can cover infertility treatments but would like to keep my husbands insurance as well as it is a good policy but lacking infertility coverage

Kerri on

I have a unique situation. I currently live in NY but will be moving to FL in January. I will be still working for my NY employer but remotely from my FL home house & keeping Ins. as is. Now my office offers a HMO I have & is great (but only for NY docs)… now this is where it gets interesting. I need to keep this coverage as my husband who only 46 is on a NY Transplant List & just now qualifies for Medicare A & B & has my office Med Ins. as his Supplement & Medicines. (46yr old is too young to qualify for AARP Supplement) Which is fine because we plan to fly to Mount Sinai Hospital in NYC every 6 months. Thing is in order to stay on Transplant list he needs to have blood work & MRI ever 3 months while we are in FL. (our NY HMO will nit cover that). So he need Ins. for NY fro the important stuff but also Ins in FL for day to day stuff. Is it possible to get an Obamacare policy in FL for standard Doc visits, blood work, MRI in FL but still keep NY Med. Ins. Please advise

betty on

my husband is retired with medicare & has a supplement insurance. he started to work & they have health insurance.can he keep his supplement & also take there insurance so he can cover himself & me

Erin on

There are no limitations on the number of health insurance policies that people get for themselves or their families. The only restrictions have to do with being eligible for cost assistance when purchasing private health insurance through the marketplaces, which you and your family will not be eligible for if your husband’s employer is offering affordable health insurance. He may want to contact the insurer for the employer though and find out how they function when combined with supplemental insurance. Insurers tend to try and avoid paying out as often as possible and this can occasionally cause frustration and/or confusion when you have more than one insurance policy covering care. Best to find out from the insurers involved directly how these plans will coordinate with each other.

John on

I have an employer sponsored HMO plan with Kaiser Permanente. I want to buy a PPO insurance also for myself to get benefits of both. Will I face any problems if I do this ?

marvin T thompson on

I wanted to know can someone have two active individual ACA policies that they are the subscriber/policy holder on?

Mike Nemecek on

My daughter’s mother and I divorced 9 years ago. In the divorce decree we are both to keep health insurance on her. We have done so up until this point. One being the primary and the other secondary. My heart insurance co just told me they wouldn’t cover her, because she already has insurance and you can not have two polices. How does this work and what do I do about it?

M Kirk on

Can a individual have two insurance plans through the federal marketplace exchange?

ESTHER A BOWEN on

I have both fiddles and health first and was told by my dentist that I need to drop one to see them there is no deductible on either what should ZI do

ObamaCareFacts.com on

Hmm, hard to say. If you haven’t used either, both are free, and both have no deductible then it is a toss up. If you have used one, then keeping that one probably makes sense.

The bottom line is I wouldn’t know which one to drop, but you should ask your dentist if they prefer one of the two.

JL on

I currently have a subsidized Health plan through the marketplace due to a lost job. I have an opportunity to take a new job that is just temp to hire, which may only last 1-2 months. They might offer health insurance. If the job turns into permanent I would then drop my personal subsidized plan and stay on the employer health plan. If the job doesn’t last then in a month I don’t have to worry about getting all set up again and starting all over with deductibles, etc.

Can I have both plans legally through Obamacare?

Thank you!

ObamaCareFacts.com on

Generally if you have access to employer coverage, for any reason, you can’t get marketplace assistance in the months you have coverage. You could keep your plan, but not the assistance. This puts you in somewhat of an odd space where the correct thing to do would be to switch to the employer plan and then back to the marketplace plan via special enrollment when it is done (or to keep the marketplace plan but not use subsidies for the months when you are offered the work plan).

That is general advice, because the situation is complex, you should call healthcare.gov and get direction from them.

Glenda on

i if they give you Medicaid can you keep your Obamacare insurance?

ObamaCareFacts.com on

You would not keep ObamaCare coverage if you have full benefit Medicaid coverage. You should contact the marketplace to make sure you fully understand your situation, then assuming you have Medicaid, you should drop your marketplace plan (but do this on the phone with assistance so you don’t end up making a mistake like being mistaken about the extent of your Medicaid coverage).

Debra on

If I have plan A with social security and a health insurance plan to cover what they don’t pay, should I still have a $5,000 bill after emergency surgery? I’m disabled and continued my health care with the federal gov. as a suplimentary insurance. This is what S.S. told me to do, since I already had it, back in 1999. Now, I have a $5,000 bill and can’t understand why. I was told the ER kept me as an out patient, therefore plan A was not covered and my other insurance was responsible. What? I just don’t understand. Plan A is my primary insurance.

ObamaCareFacts.com on
Rebecca on

I retired early from at&t .at age 55and was able to keep my health insurance for life ….I’m going to go back to work for the state of texas soon..and was wondering can i accept there health insurance as well as the company pays for it and pays 50 % for my husband with this be ok to have as well.

Jason on

As per usual no concise answers are given. Useing myself as an example: My employer ( Deseret Laboratories Inc.) provided health insurance is literally a joke and the benefits have actually decreased. Since I have already reached the maximum out of pocket expense refund allowed by the policy (2500.00) any additional out of pocket expenses will not be refunded. In trying to find out if I can purchase a additional insurance policy, the overwhelming answer is a resounding maybe to no.
The ACA otherwise known as Obamacare has literally created more problems than it has solved. Medical costs have continued to skyrocket while coverage has remained the same and or decreased, yet the ACA has done nothing to address this at all and is essentially a jobs program.
So I’m trying to find an additional health insurance policy and the answer I get is to bad your screwed

ObamaCareFacts.com on

I updated the answer to give a concise answer.

The specific answer to your question is yes, you can hold more than one policy… you just can’t get assistance on the individual/family policy because you technically have access to “affordable employer coverage.”

Himanshu Kothari on

The statement that one individual can have two independent health coverage plans during year 2018 is completely ILEGAL as per Market Place and Affordable Care Act provisions applicable entirely to USA ..

These facts can be verifies at Market Place by visitng their web site HEATHCARE.GOV and calling them on their land line.

ObamaCareFacts.com on

I can double check, but I know people have dual coverage all the time. That said, I am very sure you can’t have two subsidized marketplace plans, and it could very well be that if you have access to another coverage type, you can’t also get marketplace coverage with assistance (true for employer coverage, Medicaid, and Medicare; not sure about private plans).

Thanks for your feedback though, I will double check the rules.

Lena on

If you have doctors in two different states, one you permanently live in and one that you live in from time to time, can you have a affordable act policy from both states.

ObamaCareFacts.com on

You can’t hold two polices with cost assistance at the same time. Instead, you generally would need a single multi-state plan, when you enroll in a plan make sure find one that is a multi-state plan (usually a PPO). Make sure to double check the plan and maybe even call the insurer and your doctors before enrolling as well to confirm your plan would cover both doctors in both states.