does dual insurance make sense for me? how much of a headache will it be?
My employer health insurance, has my drs + specialists in-network, $1500 deductible and $2k OOP max but terrible fertility benefits. We partially used fertility benefits this year and then decided to pause treatment so I could switch plans.
My partner’s health plan with Anthem, and my drs and specialists are OON with only 70% of allowed amount covered, but it has great fertility benefits (progeny) at our provider of choice. Has a $10k OON OOP max.
If fertility is successful, we’d be using OON drs for all checkups / labs etc, and having the baby in an OON hospital. It’s also likely I need 1 or 2 other fairly expensive procedures done this year also OON. I also am assuming any labs with my current providers would be OON as well.. so it seems like the balance billing would add up FAST if I take my partner's health insurance only.
Does dual insurance make sense & what should I look out for (gotchas, caveats, etc) when evaluating?
Concerns with dual I see might be —
COB causing delays in getting treatment (but since primary will cover most things, it seems this may only apply to fertility treatments? Which we could get around by paying OOP and getting reimbursed?) I will have to “use up” my not-great fertility coverage with my primary first before accessing the better progeny insurance. I don’t understand how this works if I have to exhaust all parts of it before secondary kicks in? (Current insurance has limits/rules on egg retrievals & # of embryos that can be stored before transfer attempts, you can’t “bank” embryos for future use. we want to bank embryos) Specialty prescriptions — i have some that are already a struggle to get approved, concerns over neither insurance wanting to pay for them / approve them….
What else? How do I find out the answers? Switching to in network for treatments is not an option.
submitted by /u/brunchyum123
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