health insurance question-primary/secondary, young adult

[teachermom2834]

We have never had access to more than one insurance plan so I'm not clear on how this works.

Ds, 22 yo, is starting his first professional job with benefits. He can, as far as I understand, stay on dh's company family policy until age 26 regardless of whether ds company offers him insurance.

We just pay a flat family rate so it doesn't cost us anything to keep ds on ours. Ds has access to a very inexpensive plan (like $9 per biweekly pay period). He is very healthy and hasn't had any medical care in the last few years.  I think that we should keep ds on ours and he can access the vision and dental without adding those to his own basic plan. But he will still have his own medical in case dh loses his job, etc. Plus, with the low cost plan through his employer, ds can make use of saving in an HSA which he wants to do.

Am I misunderstanding something about the law or regulations about keeping ds on our insurance? And, how does that work for ds? He will have coverage through two different insurance plans. Does he pick one to be a primary and one to be a secondary? Does it matter which from a legal perspective? 

My thought is that he should keep our family insurance as the primary because we as a family will likely meet the deductible before he meets his individually. 

I'm not sure I'm completely understanding how this works. Anyone with experience with this? 

[vonfirmath]

15 minutes ago, teachermom2834 said:

We have never had access to more than one insurance plan so I'm not clear on how this works.

Ds, 22 yo, is starting his first professional job with benefits. He can, as far as I understand, stay on dh's company family policy until age 26 regardless of whether ds company offers him insurance.

We just pay a flat family rate so it doesn't cost us anything to keep ds on ours. Ds has access to a very inexpensive plan (like $9 per biweekly pay period). He is very healthy and hasn't had any medical care in the last few years.  I think that we should keep ds on ours and he can access the vision and dental without adding those to his own basic plan. But he will still have his own medical in case dh loses his job, etc. Plus, with the low cost plan through his employer, ds can make use of saving in an HSA which he wants to do.

Am I misunderstanding something about the law or regulations about keeping ds on our insurance? And, how does that work for ds? He will have coverage through two different insurance plans. Does he pick one to be a primary and one to be a secondary? Does it matter which from a legal perspective? 

My thought is that he should keep our family insurance as the primary because we as a family will likely meet the deductible before he meets his individually. 

I'm not sure I'm completely understanding how this works. Anyone with experience with this? 

I'm not sure he'll be allowed to keep your family insurance as primary -- this would be something to talk to your health insurance about.

 

My work has a family plan and my husband has a job. But his employer's insurance is his primary and mine is only secondary and I don't think we can change that.

Edited September 29, 2020 by vonfirmath

[Carrie12345]

I’m not clear on the ACA regulations for young adults with additional employer insurance. I can tell you that any time our kids, or even myself as a kid, had two insurance plans, primary was always by the policy holder with the birthdate that comes first on the calendar and secondary was the later birthdate.

[Pawz4me]

I think you (and/or he) will need to call the insurance companies to find out. You can't just choose which one is primary and which one is secondary. It will almost certainly be spelled out in the coverage documents somewhere. When I was working and DH also had me on his insurance through his employer my own insurance through my employer was primary and my coverage under DH's plan was secondary. My *guess* is that's how it would work with your DS--his own coverage through his employer would be primary and your family coverage would be secondary. But that's absolutely a guess.

[Scarlett]

10 minutes ago, Carrie12345 said:

I’m not clear on the ACA regulations for young adults with additional employer insurance. I can tell you that any time our kids, or even myself as a kid, had two insurance plans, primary was always by the policy holder with the birthdate that comes first on the calendar and secondary was the later birthdate.

Yes, this is how it was for me during the brief period of ds’s infancy that we had two insurance.

[Scarlett]

 And depending on how expensive either deductible is it might be worth the hassle of coordinating benefits of both plans.  

[teachermom2834]

19 minutes ago, HeighHo said:

Take a look also at your  plan's coverage in his area, as well as the coverage in areas he is likely to travel too. If your family plan is mostly out of network for most providers in his area, he is better off on his company's plan. 

Also do the math.  He may benefit more from funding his HSA than having one or two free appts because the family deductible was met before he went to the provider.

He is going to fully fund his HSA regardless. Are you saying he couldn’t do that if he had our family as primary?

[teachermom2834]

11 minutes ago, Scarlett said:

 And depending on how expensive either deductible is it might be worth the hassle of coordinating benefits of both plans.  

Yeah I think it would be worth the hassle. I just can’t see removing him from our plan if it isn’t costing anything for him to be on it, and it is legal.

[teachermom2834]

31 minutes ago, vonfirmath said:

I'm not sure he'll be allowed to keep your family insurance as primary -- this would be something to talk to your health insurance about.

 

My work has a family plan and my husband has a job. But his employer's insurance is his primary and mine is only secondary and I don't think we can change that.

I can see how our family insurance would not allow him to use it for a primary if he had other insurance. That makes sense. We’ll call and make sure. I now remember that every year our family insurance makes me verify that I don’t have any other insurance that should be my primary. I wouldn’t be surprised to start needing to verify that for adult kids at some point too.

I’m fine with him using ours as secondary. I am just trying to think through the scenario and figure out what questions he even needs to ask.

[teachermom2834]

5 minutes ago, HeighHo said:

Do you have an HSA?  You need to research the fine print on both plans plus the HSA rules.  Here's a taste: https://ttlc.intuit.com/community/tax-credits-deductions/discussion/i-am-an-independent-child-under-my-parents-insurance-plan-i-m-24-can-i-still-be-covered-by-my/00/233052 .  If this year he was a dependent for part of the year, next year's decision may be different...find out when open enrollment begins for 2021 for him. He may be better off on your plan this year and his next. All depends on details.

Thanks. That’s very confusing. We do have a high deductible plan with an HSA for our family. We haven’t claimed him as a dependent since 2018 so that isn’t complicated. 

[City Mouse]

3 hours ago, Carrie12345 said:

I’m not clear on the ACA regulations for young adults with additional employer insurance. I can tell you that any time our kids, or even myself as a kid, had two insurance plans, primary was always by the policy holder with the birthdate that comes first on the calendar and secondary was the later birthdate.

This is how it worked for us as well.

When DD has her own insurance, her’s was primary and the parent’s insurance was secondary. We never had to do anything. The medical offices would bill the primary first. Once that payment got to them, then they would bill the secondary insurance. Where we live, most offices will wait to bill the patient until after insurance pays (even for the co-pay), but we live in a low income area.

[GoodGrief]

My daughter had two insurance plans, one through the school and one through my husband. We never got to select which was primary. Oddly enough, the Tricare (military) insurance is typically secondary, though with her school plan, it became the primary insurance. Now we have two plans, because of my husband's recent retirement. The Tricare is secondary, and the insurance through his new job is primary.

Be aware that you are supposed to notify each insurance of the existence of the other, and even after you do that (perhaps multiple times), they will likely still ask you for that information regularly. So annoying.

[TrixieB]

If your son decided to enroll in the insurance plan that his employer offers, it would be his primary plan (because he is the subscriber).  If he also stayed on your family's plan, that plan would be secondary (because a person other than your son is the subscriber).  You don't get to choose which plan is primary.  

You might check with your family's insurance to be sure he could still be covered under the policy, if he will be working full time for an employer that offers heath insurance.  Sometimes there are exclusions.