Dual health insurance in CA

[Henryh1]

We have Kaiser HMO through my employer, which is great for routine health care, but would like to get a second health insurance plan (PPO) in case we want to go to a specialist in a non-Kaiser hospital.

Would Kaiser need to be notified or need to coordinate anything if we have a second insurance plan since we would only use the second plan when going out of network?

 

[adjusterjack]

It's likely that both policies would have a coordination of benefits provision which means that they each should be notified of the other.

Read your Kaiser policy or booklet to see what it says about other coverage.

And make sure you are able to read your new policy before you buy it.

 

[somarco]

For starters, you don't get to pick which plan is primary.

Your employer HMO is primary, a secondary plan (presumably individual insurance) is secondary. Unless you qualify for a subsidy, that secondary (backup) plan might be quite expensive.

You will not profit by having two plans . . . at best you might get your claim paid at 100% of the repriced amount.

Even if you cobble something together that LOOKS like it MIGHT work, consider you have two separate deductibles and two OOP maximums.

Tell me again why you think this is a good idea . . .

 

[PhxSunsFan]

for someone with priv insurance that wants to keep it during their medicare years because they use a lot of chiro and pt and their current priv insurance pays everything with no ded and no referral needed,.,,.. thinking they enroll in A and also D but dont need a supp or C ??