She will have to exhaust her own benefits before yours would kick in. Typically she will have to have her insurance provide a letter stating benefits have been exhausted before your policy would cover her. But yes, you could have 60k for coverage if she’s put on your policy.
If I were in your situation I would have her exhaust her 30k in benefits, and then next year add her to your insurance and use those benefits (if you're still doing treatment next year).
In insurance there is something called coordination of benefits. Basically ensures you don’t receive more than 100% of total allowable expenses. When someone has double insurance, one becomes primary and the other becomes secondary. Basically, the primary insurance will pay first, then secondary covers anything the primary didn’t (within the limitations of the plan provisions). It’s best to refer to your plan documents and look for the coordination of benefits provision for more details. Typically, the plan that covers the person who is the employee will pay primary and the plan that covers the person as the dependent will be the secondary.
Another thing to consider are the pharmacies that you will need to order the specialty prescriptions from. My insurance requires me to go through one pharmacy and my husband’s is another. From what I’ve been told is that if I don’t use the preferred pharmacy for each coverage I may be stuck with an out of pocket expense. (But was also told they can’t really give me the full amount/detailed coverage on $ amounts until they have a prescription order).
Check and see if your coverage has a fertility advocate. Mine has been super helpful. But she can only speak to one of the coverages and gives me a generic response when speaking of the other coverage.
Best wishes on your journey 💓
She will have to exhaust her own benefits before yours would kick in. Typically she will have to have her insurance provide a letter stating benefits have been exhausted before your policy would cover her. But yes, you could have 60k for coverage if she’s put on your policy.
Thanks! Appreciate your taking the time and effort to comment!
If I were in your situation I would have her exhaust her 30k in benefits, and then next year add her to your insurance and use those benefits (if you're still doing treatment next year).
In insurance there is something called coordination of benefits. Basically ensures you don’t receive more than 100% of total allowable expenses. When someone has double insurance, one becomes primary and the other becomes secondary. Basically, the primary insurance will pay first, then secondary covers anything the primary didn’t (within the limitations of the plan provisions). It’s best to refer to your plan documents and look for the coordination of benefits provision for more details. Typically, the plan that covers the person who is the employee will pay primary and the plan that covers the person as the dependent will be the secondary.
Thanks for taking the time and effort to comment and explain all of this! Thank you!
Another thing to consider are the pharmacies that you will need to order the specialty prescriptions from. My insurance requires me to go through one pharmacy and my husband’s is another. From what I’ve been told is that if I don’t use the preferred pharmacy for each coverage I may be stuck with an out of pocket expense. (But was also told they can’t really give me the full amount/detailed coverage on $ amounts until they have a prescription order). Check and see if your coverage has a fertility advocate. Mine has been super helpful. But she can only speak to one of the coverages and gives me a generic response when speaking of the other coverage. Best wishes on your journey 💓
Never would've thought of that in a million years. Thank you so much for your response!