I have double coverage. one insurance pays more than the other. Do they have to pay 100% between both?

Question

How do insurances work when you have double coverage. For example, doctors full bill is $1000.00. Primary insurance covers 80% and validates the price of the doctors bill is 1000.00. So they pay $800.00. The secondary insurance is suposse to pay also 80%. The secondary insurance determines the doctor's fees are $700.00 because he is one of their doctors under their plan. So they shout pay $560. Now because the primary insurance paid $800 dollars, the secondary insurance won't pay anything because the primary insurance allready cover what the doctor was supposed to get paid under their agreement. However I am stocked to pay $200 dollars.

Answer 1

Most of the time they will not pay in full.  Each policy will have a provision in it, for how their coverage applies if there are more than one policy  in force for you.

That's why it's rarely worth it to pay for two health insurance policies.  The ONLY time you really can end up with nothing out of pocket, is if the secondary coverage is WELFARE insurance - medicaid or medicare.

Answer 2

Unfortunately, you are correct. Usually the secondary coverage will only pay UP TO what they would have paid if they were primary, so if the primary paid 70% and the secondary would have paid 80% (as primary) the secondary would have kicked in another 10%.

The only advantage to having 2 insurances (usually) is if one has a benefit for something that the other doesn't have (e.g. chiropractic).

Answer 3

You have it figured out correctly you owe the $200

In most cases have double insurance is a waste of money.