Can you have two health insurances?

Key takeaways 

• Yes, you can have two health insurance plans — and it’s completely acceptable. Dual coverage can happen in a variety of situations including when you’re covered by your own job and your spouse’s plan; when a child is insured under both parents; or if you’re transitioning between jobs and have overlapping COBRA coverage. In each case, one plan becomes the primary insurer (pays first), while the second becomes secondary and may help pay remaining eligible costs.
 • “Coordination of benefits” rules decide which plan pays first. If you’re covered under your own employer plan and also as a dependent (like through a spouse), your own employer coverage is usually primary. For dependent children, insurers typically follow the “birthday rule” — the parent whose birthday falls earlier in the calendar year provides the primary coverage. If COBRA overlaps with active employer coverage, the active plan is primary.
 • Dual coverage may reduce your out-of-pocket costs — but not always. Having two plans can be helpful if one plan doesn’t cover certain services, or if you’re frequently paying deductibles or copays. But both plans coordinate to ensure they don’t pay more than 100% of the bill. In some cases, the secondary plan might not pay anything if the primary plan already covered the maximum allowable amount.

Is dual health insurance for you?

Health care is expensive, so it’s natural to ask: “Can I have two health insurance plans?” The answer is yes — and about 6% of people with insurance do.

According to a projection of 2025 health insurance coverage from the Congressional Budget Office, out of 319 insured people, 20 million people (about the population of New York) may have more than one plan.

Before choosing dual coverage, it’s important to fully understand how primary vs. secondary insurance policies operate. Even though it may sound like more work having two individual or family health insurance plans, having a second health insurance plan can help you cover some of your insurance expenses.

On the other hand, you might also be responsible for two monthly premiums and two deductibles. Therefore, as you consider getting a second long or short-term health insurance plan, you need to think carefully about what would suit your situation the best.

What’s the difference between primary and secondary insurance?

• Primary insurance: This is the insurance plan that pays first when you receive medical care. It covers eligible costs up to its coverage limits. After that, you may still owe premiums, deductibles, copays, or coinsurance.

• Secondary insurance: Once your primary insurance has paid its share, the remaining bill goes to your “secondary” insurance, if you have more than one health plan. Your secondary insurance may cover part or all of the remaining costs.

So, how do insurers know which plan is your primary plan? The order of payment is determined by something called Coordination of Benefits rules.

These are standardized guidelines insurers use to decide which of your plans takes the lead, based on your relationship to each plan, your employment status, and other factors.

For an easier visual, here is a list of primary vs. secondary insurance situations and how it would be determined which one is your primary plan:

Primary vs. secondary insurance: Who pays first?

Types of coverage:	Primary insurance:	Secondary insurance:
Employer coverage and spouse’s plan	Your employer plan	Spouse’s employer plan
Dependent under both parents’ plans	Parent whose birthday is earlier in the calendar year (known as the “birthday rule”)	Other parent’s plan
Covered by both parents and one parent has a court order for responsibility	The plan of the parent with court-ordered responsibility	Other parent’s plan
Employer coverage from two different jobs	The plan from the job where you work more hours or longer	Plan from the second job
Active employer coverage and COBRA from a former job	Active employer coverage	COBRA plan
Private insurance and Medicaid	Private insurance	Medicaid (always pays last)
Medicare and an employer plan (employer has 20+ employees)	Employer plan	Medicare
Medicare and an employer plan (employer has < 20 employees)	Medicare	Employer plan
TRICARE (military health insurance program) and employer coverage	Employer plan	TRICARE (unless you’re active-duty military)
School insurance and also on a parent’s plan	Typically the parent’s plan (if you’re a dependent)	Student plan (depends on plan rules)
Two individual private plans	The plan you enrolled in first	The plan you enrolled in second

Note: If you’re still unsure which plan is your primary, check your plan documents or contact your insurers. You can also ask your healthcare provider’s billing office — they often deal with Coordination of Benefits rules and may be able to help guide you.

How might having two health insurances look for you?

Let’s look at different example scenarios of people having dual health insurance, to help you get an even better idea of how two plans might work for you or your family — and when and how much secondary insurance might help you pay.

Examples of dual health insurance coverage:

Name & Scenario	Type of Coverage	Primary Insurance	Secondary Insurance	Sample Medical Service	How it works
Jane (Employee that is also on a spouse’s plan)	Employer plan + Spouse’s plan	Jane’s employer plan	Spouse’s employer plan	$1,200 outpatient specialist visit	Jane’s employer plan pays $900. Spouse’s plan pays $250. Jane pays $50.
Marcus (Employee on two employer plans)	Two part-time employer plans	Job A plan	Job B plan	$3,000 MRI scan	Job A plan pays $2,200. Job B plan covers $700. Marcus pays $100.
Ava (Child on two parent plans)	Both parents’ employer plans	Parent with earlier birthday	Other parent	$1,000 urgent care visit	Parent A’s plan pays $800. Parent B’s plan pays $180. Family pays $20.
Ben (New employee that also still has COBRA)	Employer plan + COBRA from old job	New employer plan	COBRA	$5,000 outpatient surgery	New plan pays $3,500. COBRA pays $1,200. Ben pays $300.
Leila (Enrolled in a Marketplace plan and Medicaid)	Marketplace plan + Medicaid	Marketplace plan	Medicaid	$750 lab work + follow-up	Marketplace plan pays $500. Medicaid pays $240. Leila pays $10.
Carlos (On an employer plan and a secondary plan with a high deductible)	Employer plan + older private plan	Employer plan	Private plan with unmet deductible	$2,200 outpatient physical therapy	Employer plan pays $1,500. Secondary plan has a $2,500 deductible not yet met, so it pays $0. Carlos pays $700 out of pocket.

Note: All numbers are fictional but realistic based on average U.S. out-of-pocket and insurer reimbursement rates.

Why didn’t Carlos’s second plan help?

Note that in the above fictional scenario, even though Carlos had a second health plan, it came with its own high deductible, which hadn’t been met yet. Because of that, the secondary plan didn’t contribute — a common issue when dual plans each have separate deductibles and cost-sharing rules.

Other reasons a second plan might not pay

Here are more situations that may prevent a secondary plan from covering any of a medical service:

• Duplicate coverage exclusions: Some secondary plans will not allow payment if the primary plan has already covered the service.
• Lack of benefit overlap: If the service isn’t covered under the secondary plan, it may not pay anything.
• Improper claim submission: Failure to submit the necessary documentation, such as the explanation of benefits from the primary insurer, can result in the secondary insurer denying payment.

Pros and cons of having two health insurances

Let’s look more closely at the reasons you may want or decide not to get two health insurance plans, if this option is available to you.

Key benefits of dual health insurance

1. Lower out-of-pocket costs:
   When you have two plans, your secondary insurance may help pay for expenses your primary plan doesn’t fully cover — like deductibles, copays, or coinsurance — resulting in less money out of your pocket.
2. More comprehensive coverage:
   If one plan doesn’t cover a specific treatment or service, your secondary plan might. This can give you broader access to care, especially if the two plans offer different benefits.
3. Added financial protection:
   Dual coverage can offer a safety net if you experience a major medical event or chronic illness. It can help limit how much you owe for large medical bills.
4. Coverage while transitioning:
   Having overlapping plans — like when starting a new job or changing coverage — can prevent gaps in care or delays in treatment.

Potential downsides of dual health insurance

1. No double payouts:
   You won’t get reimbursed twice for the same service. The secondary insurance only pays what the primary doesn’t—up to the amount it would cover on its own.
2. Higher premium costs (sometimes):
   If you or a family member are paying for both plans (like through payroll deductions), your combined premium costs could be higher than the savings you get from extra coverage.
3. Provider network confusion:
   Your two plans may have different in-network doctors or hospitals. It might be harder to find providers who accept both, especially if one is an HMO.
4. More complex billing and paperwork:
   Coordinating benefits between two insurers can be confusing. Claims may take longer to process, and you might have to track bills and coverage details more closely.

How to apply for and manage two health insurance plans

Now that you know more about having two health insurance plans, let’s look at the steps needed to enroll in them.

Step-by-step guide to applying for dual health coverage

1. Identify eligible plans: Some combinations (like employer + Marketplace) may conflict or impact subsidies (financial assistance). Before enrolling, check if your situation supports dual coverage legally and financially.
2. Coordinate enrollment timelines: Pay attention to enrollment periods so you don’t miss out. For example:
   • Employer plans typically have an open enrollment period once a year.
   • Marketplace plans have an annual open enrollment period (usually Nov – Jan) or require a qualifying life event.
   • Medicaid/TRICARE can be applied for anytime, depending on your eligibility.
3. Disclose dual coverage when enrolling: Always notify each insurer if you have another health plan. This ensures proper Coordination of Benefits (COB) and helps avoid claim denials or delays.
4. Use a licensed insurance agency like eHealth: Agencies like eHealth offer side-by-side comparisons of plans, and pricing is legally standardized—so it costs the same whether you shop through eHealth or directly through the insurer.

Key factors to consider when managing two insurance plans

Before committing to two plans, consider the following:

• Premiums: You’ll pay monthly for both plans — can you afford that long term?
• Deductibles & copays: Each plan may have separate deductibles, copays, and coinsurance amounts.
• Provider networks: Are your doctors in-network for both plans? If not, secondary insurance may not cover much.
• Out-of-pocket maximums: Having two plans can help you reach the out-of-pocket maximum amount that you need to pay faster, but not always.
• Coordination of Benefits (COB): Know which plan pays first (primary) and second (secondary). Misunderstanding this can lead to rejected claims or delays.
• Plan compatibility: For example, being on an employer plan and enrolling in a subsidized Marketplace plan could cause you to lose financial assistance, or a subsidy.

Be proactive with documentation

• Keep all Explanation of Benefits (EOBs) from your primary insurer to send to the secondary plan.
• Communicate with HR or your broker if your coverage changes midyear due to job switches, marriage, or other qualifying events.
• Re-evaluate annually during open enrollment to see if dual coverage is still cost-effective.

FAQs about having multiple health insurance policies

Does having two health insurance plans lower out-of-pocket costs?

There are some situations where having two health insurance plans can help you reduce your out-of-pocket expenses. For example, if you have two health insurance plans that cover different areas of your medical needs, then one policy may cover one area while another policy covers the other area. That way, you may reduce your out-of-pocket expenses.

Are there different types of secondary insurance?

Yes, there are different types of secondary insurance coverage. You may want to find a plan that targets the area of your coverage that you require the most. Vision, dental, disability, hospital care, and Medicare supplement insurance are just some of the areas that secondary insurance can focus on helping you with in addition to your primary insurance.

For example, if your primary plan does not cover a lot of your hospital costs and you think you will be needing hospital care in the future for a major surgery or for an extended period, a secondary hospital care insurance may be right for you.

Does the secondary insurance cover copays?

Yes, in some cases, your secondary insurance may cover your copay — but it depends on the specific details of both plans. For example, if your primary insurance requires you to pay a $30 copay for a doctor’s visit, your secondary plan might cover all or part of that amount. However, this isn’t always guaranteed.

Whether or not the copay is covered depends on what your secondary plan includes, whether the provider is in-network for both plans, and how the coordination of benefits is set up. Some secondary plans are designed to fill in coverage gaps, while others may have their own copay rules or exclude certain costs. It’s important to check with both insurance providers to understand exactly what each plan will pay.

How does billing work?

If you have primary and secondary health insurance, your claim will not be given to both policies at the same time. Your primary insurance will typically be billed first unless there is a rule under your Coordination of Benefits provision that decides which insurance pays first.

Once your primary insurance has done its part, you can then send the claim on to your secondary insurance. Keep in mind that you should always send the full claim to your secondary insurance provider as they will want to see what your primary insurance has already paid and why the claim was not fully paid by them. Sending a total claim can prevent your secondary payment from being rejected.

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