Health insurance coverage question, double covered

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TheSiege

Diamond Member
Jun 5, 2004
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Both my Ex and I have insurance on our kids. Mine covers 2 hospitals in the area, and her covers the third. So they don't overlap at all. Which one should I take my children to? Her birthday is in Jan and mine is in Feb. And hers is medicaid and mine is a typical insurance plan.
 

sactoking

Diamond Member
Sep 24, 2007
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You'd have to check the coordination of benefits clause in your policy and the Medicaid coordination laws in your state.
 

JEDI

Lifer
Sep 25, 2001
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Both my Ex and I have insurance on our kids. Mine covers 2 hospitals in the area, and her covers the third. So they don't overlap at all. Which one should I take my children to? Her birthday is in Jan and mine is in Feb. And hers is medicaid and mine is a typical insurance plan.

the better one? (i'm betting yours)

and what does bday have to do w/this?!
 

TheSiege

Diamond Member
Jun 5, 2004
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the better one? (i'm betting yours)

and what does bday have to do w/this?!

I thought I read somewhere once that primary insurance was decided by who was born first in the year, so I thought I would mention it.
 

lupi

Lifer
Apr 8, 2001
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Call your insurance. My guestimate would they'd be happy to make medicaid pay for everything they can, but since it's medicaid then the private insurance may be considered the primary.
 

mikeford

Diamond Member
Jan 27, 2001
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Considering how Obamacare works, likely you now have two deductibles before they pay anything.
 

Gooberlx2

Lifer
May 4, 2001
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I'm assuming the medicaid insurance is free for the kids? They probably shouldn't even qualify for medicaid coverage since they can be covered under yours...at least from what I remember from the last time I looked into medicaid for a family member. Maybe it varies by state.

I'd bet dollars to donuts that your insurance will be considered primary.
 

TheSiege

Diamond Member
Jun 5, 2004
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I dont think my ex is being honest and/or she is being ignorant of the rules. But that is her shit to deal with. I'll just consider mine primary
 

lupi

Lifer
Apr 8, 2001
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judging from a couple minutes doing the google, if she has primary custody and has a low enough income then she could get medicaid but with a full service private health plan you'll likely be considered the primary plan whenever the child receives treatment. that of course assumes the medicaid plan actually exist. you could still call your and ask cause they should be able to answer that rather quickly.
 

Hayabusa Rider

Admin Emeritus & Elite Member
Jan 26, 2000
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You'd have to check the coordination of benefits clause in your policy and the Medicaid coordination laws in your state.

Medicaid is always payer of last resort. If there is another policy it must come first. I believe this is a federal requirement, or at least that's what we are told.
 

alkemyst

No Lifer
Feb 13, 2001
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Medicaid is always payer of last resort. If there is another policy it must come first. I believe this is a federal requirement, or at least that's what we are told.

That is true. Like many have said, one of the questions you are asked when applying for medicaid is if there is other insurance. You can have medicaid and another insurance policy, they sometimes will pick up where the primary leaves off.

The benefits coordinator will be your main ally. Not all hospitals are equal in how they take / apply coverage. That should be your route providing all the hospitals give equal care.
 
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