Is secondary insurance for kids (via NCP) worth it?

[kells76]

The kids are insured at Mom's house through their mom's husband (their stepdad).

In the past, I'd assumed it was "illegal" for the kids to also be on insurance at Dad's house (it'd be through me, stepmom). Found out last year it isn't.

We've run into issues in the past where one of the kids needs urgent care, and we're sitting in urgent care needing a kid to get stitches, and urgent care is saying "we won't start until we know insurance info", and Mom or Stepdad aren't answering their phones with insurance info. Mom/Stepdad tend to withhold information and don't voluntarily share any insurance info/updates with us.

Does anyone have experience with getting 2' insurance for their kids? Would it solve problems like the above -- a provider needs some kind of insurance info to start an urgent treatment, so 2' insurance would count for that?

What unforeseen issues did you encounter? For example, was 2' insurance only "allowed" to cover a small amount of treatment, and then whoever had 1' insurance was "stuck with the bill"? (There is a lot of conflict and negativity from Mom's house over us doing ANY kind of medical/dental/etc care for the kids, whether routine or emergency, and there has been at least one passive aggressive snipe over them getting an urgent care bill from when we took a kid). If this just creates openings for more conflict/blame, I'm not sure I want to go there.

If a provider is out of network on 1' insurance but in network on 2' insurance, how has that played out in real life?

Would be very grateful to hear any experiences/suggestions/warnings.

[stolencrumbs]

The kids are insured at Mom's house through their mom's husband (their stepdad).

In the past, I'd assumed it was "illegal" for the kids to also be on insurance at Dad's house (it'd be through me, stepmom). Found out last year it isn't.

We've run into issues in the past where one of the kids needs urgent care, and we're sitting in urgent care needing a kid to get stitches, and urgent care is saying "we won't start until we know insurance info", and Mom or Stepdad aren't answering their phones with insurance info. Mom/Stepdad tend to withhold information and don't voluntarily share any insurance info/updates with us.

Does anyone have experience with getting 2' insurance for their kids? Would it solve problems like the above -- a provider needs some kind of insurance info to start an urgent treatment, so 2' insurance would count for that?

What unforeseen issues did you encounter? For example, was 2' insurance only "allowed" to cover a small amount of treatment, and then whoever had 1' insurance was "stuck with the bill"? (There is a lot of conflict and negativity from Mom's house over us doing ANY kind of medical/dental/etc care for the kids, whether routine or emergency, and there has been at least one passive aggressive snipe over them getting an urgent care bill from when we took a kid). If this just creates openings for more conflict/blame, I'm not sure I want to go there.

If a provider is out of network on 1' insurance but in network on 2' insurance, how has that played out in real life?

Would be very grateful to hear any experiences/suggestions/warnings.

I don't have kids, but my ex-wife had dual plans for a bit through my and her employer.

It might help with the urgent care situation, but it might not. If it helps, it will just be because the urgent care center didn't check on the insurance before initiating care. When you have two plans, one of the plans will be designated as the primary plan, and every claim gets sent to the primary insurer first. The secondary insurer isn't going to entertain paying anything unless and until they see what the primary insurer paid.

I think that sort of answers your other question. Yes, the secondary insurer is only going to pay a small amount. The primary insurer is going to be responsible for whatever the plan makes them responsible for, then the secondary plan is going to see what is left or what you had to pay and apply their own coverage plan to that.

I haven't dealt with the in-network/out-of-network issue with dual insurers. It probably depends on the insurer.

In general, the few times we had to deal with both insurance companies, it required some coordination that would've been difficult if the person with the other policy wasn't willing to be cooperative. For the most part, the insurance companies will sort out who pays for what, but there were times when I had to talk with both of them to figure it out, or get an explanation of benefits from the primary insurer to send to the secondary insurer. That seems like it could be challenging in your situation.

[GaGrl]

Yes, as stolen crumbs says, one is designated Primary, the other is Secondary, and all plays out based on that. So you'd still be caretakers n an awkward situation trying to get insurance info for an urgent care visit, since the custodial parent (mom) has the Primary insurance.

It is ridiculous that you don't have an up-to-date copy of the girls' insurance policy info. Probably not worth a court visit though?

[ForeverDad]

If the ex has a lawyer, perhaps your lawyer could send a nice but firm letter that the children's insurance information must be provided, and kept up to date, for availability or use during your parenting time.  Or if there is a parenting coordinator...

[Couscous]

Seems to me like the most logical solution would be to add them to your insurance and remove them from the step-father’s, and then you would reduce child support payments accordingly, but I imagine this will need to be done through the court system.

Also, I found this: https://cornwell-law.com/08/help-my-ex-will-not-give-me-a-copy-of-my-childs-insurance-card/

[kells76]

Thanks all for the feedback, it helps me clarify what my issue is.

...

First of all, the kids' mom did end up finally sending me a photo of SD16's insurance card, after I asked for both the kids' info back when I was trying to set up counseling for SD14. For those who don't remember, I told her I was "updating our records". There ended up being a huge blowup once MOm found out I was setting up counseling for SD14 (https://bpdfamily.com/message_board/index.php?topic=351873.0).

Anyway, Mom believes she gave us SD14's card. We do not have it, and I think Mom has to be the one to order another one.

So, in terms of insurance information, the nutshell version is: Mom and Stepdad do not volunteer information, and if DH or I were to ask for information for "real" reasons, they would balk, stonewall, create conflict, and bring the kids into drama. I suspect the only reason she gave the insurance cards is because she has some inkling that at the end of the day she is legally required to do so in that specific area. Almost any other mental health/physical health/emotional health information about the kids that she knows she isn't required to give, she withholds as a power move, and when asked for it, wields it as a sign that the kids have chosen her as the safe/supportive parent ("They aren't emotionally prepared to have you take them to the dentist!" -- yes, we heard this).

...

In terms of lawyer involvement, the last time we had our L send a letter to Mom, she told the kids, and then SD16 (who was 12 at the time) sent a letter to DH saying "I can't believe you hired a L against your own kids". So Mom has no qualms about bringing the kids into adult drama and then manipulating the kids into hurting DH (so that Mom can hurt DH by proxy). This means we do not use our L to engage with Mom because of the profound damage to the kids. We have consulted with him on the side in order to feel empowered in knowing we're legally protected with certain choices (maintaining parenting time during Covid -- that was $$ well spent) -- but we have had to take the info from the L and then engage directly with Mom about it. If we had the L do it, she would emotionally hurt the kids with that info.

If things got really bad, yeah, we might engage him again, but it'd have to be insanely bad, and SD16 is 16.5 and turning 17 soon. The closest we've gotten is thinking about picking his brain when Mom ran off for a few months -- to see how long she'd have to be gone for it to count as abandonment. Yes it's crazy that she and Stepdad don't volunteer information. It's their MO and involving the L for anything short of a slam dunk just means allowing her to harm the kids.

Nutshell version of L involvement: unless it's a safety issue and L tells us beforehand "It's the clearest win I've seen and it'll be wrapped up really fast", we can't do it without losing the kids' hearts. That's who Mom and Stepdad are.

...

In terms of logical solutions:

Early on, like 10 years ago, back when DH and I would meet with Mom and Stepdad to "discuss" the kids, Mom was saying something about how Older SD "would of course be allowed to see you whenever she wanted" or something like that, but Younger SD "couldn't just use wanting to see you as an excuse to get out of chores". I said something like "that doesn't seem logical" and the literal words coming out of Mom's mouth, one of those cases where someone "accidentally tells you the truth", were: "Logic has nothing to do with it". I mean, she was right. For someone with strong BPD traits, married to someone with strong NPD traits, when it comes to caring about the the kids, logic has no place. It's all about her feelings in the moment. If she feels attacked or her role threatened, via DH or I "taking her role" by doing medical care for the kids, or by the possibility of a legal light being shined on her actions, her primary concern is absolutely her own emotional survival at the cost of everyone else's wellbeing. There is no logic involved and again, even though "coordination of insurance to ensure the best coverage for the kids, regardless of under whom they're insured" would logically be in the kids' best interest, it would "dethrone" her and Stepdad as "the providers, the carers, the rescuers" and therefore cannot be tolerated.

...

Anyway. All of your comments were helpful in refining what I think I'm asking, so let me put it together again:

My hope was that given the conflicts we've been through before that have arisen due to Mom paying a medical bill (Mom is primary parent and insurance is through Mom's house) generated from an emergency visit for the kids, that having 2' insurance would (a) cover the "residual" cost, and therefore (b) eliminate a source of conflict between Mom & DH.

What I think I'm hearing is that it's not a guarantee that the 1' & 2' insurance companies can "figure it out themselves", even if you provide both policies to Urgent Care (for example). You still may have to do the legwork and interact yourself with whoever has the 1' policy. So, while applying 2' insurance to a visit may decrease the $$$ owed, it may increase the contact between parents required.

Is that sounding like others' experiences?

I think what I'm now trying to figure out is: given that 2' insurance for the kids isn't that expensive, I wonder if there's any benefit to "just getting it" -- like, is there a "just in case" reason where it'd be good to have it, but it'd still be fine if we never had to use it. It's not a big $$$ outlay but I'm trying to put together a mental picture of why to get it "just in case". If the kids had a catastrophic or prolonged medical issue, I'm wondering if then the benefit of having more coverage would outweigh the downside of more interaction required between parents.

Thoughts?

[kells76]

Thanks all for the feedback, it helps me clarify what my issue is.

...

First of all, the kids' mom did end up finally sending me a photo of SD16's insurance card, after I asked for both the kids' info back when I was trying to set up counseling for SD14. For those who don't remember, I told her I was "updating our records". There ended up being a huge blowup once Mom found out I was setting up counseling for SD14 (https://bpdfamily.com/message_board/index.php?topic=351873.0).

Anyway, Mom believes she gave us SD14's physical card. We do not have it, and I think Mom has to be the one to order another one.

So, in terms of insurance information, the nutshell version is: Mom and Stepdad do not volunteer information, and if DH or I were to ask for information for "real" reasons, they would balk, stonewall, create conflict, and bring the kids into drama. I suspect the only reason she gave the insurance cards is because she has some inkling that at the end of the day she is legally required to do so in that specific area. Almost any other mental health/physical health/emotional health information about the kids that she knows she isn't required to give, she withholds as a power move, and when asked for it, wields it as a sign that the kids have chosen her as the safe/supportive parent ("They aren't emotionally prepared to have you take them to the dentist!" -- yes, we heard this).

...

In terms of lawyer involvement, the last time we had our L send a letter to Mom, she told the kids, and then SD16 (who was 12 at the time) sent a letter to DH saying "I can't believe you hired a L against your own kids". So Mom has no qualms about bringing the kids into adult drama and then manipulating the kids into hurting DH (so that Mom can hurt DH by proxy). This means we do not use our L to engage with Mom because of the profound damage to the kids. We have consulted with him on the side in order to feel empowered in knowing we're legally protected with certain choices (maintaining parenting time during Covid -- that was $$ well spent) -- but we have had to take the info from the L and then engage directly with Mom about it. If we had the L do it, she would emotionally hurt the kids with that info.

If things got really bad, yeah, we might engage him again, but it'd have to be insanely bad, and SD16 is 16.5 and turning 17 soon. The closest we've gotten is thinking about picking his brain when Mom ran off for a few months -- to see how long she'd have to be gone for it to count as abandonment. Yes it's crazy that she and Stepdad don't volunteer information. It's their MO and involving the L for anything short of a slam dunk just means allowing her to harm the kids.

Nutshell version of L involvement: unless it's a safety issue and L tells us beforehand "It's the clearest win I've seen and it'll be wrapped up really fast", we can't do it without losing the kids' hearts. That's who Mom and Stepdad are.

...

In terms of logical solutions:

Early on, like 10 years ago, back when DH and I would meet with Mom and Stepdad to "discuss" the kids, Mom was saying something about how Older SD "would of course be allowed to see you whenever she wanted" or something like that, but Younger SD "couldn't just use wanting to see you as an excuse to get out of chores". I said something like "that doesn't seem logical" and the literal words coming out of Mom's mouth, one of those cases where someone "accidentally tells you the truth", were: "Logic has nothing to do with it". I mean, she was right. For someone with strong BPD traits, married to someone with strong NPD traits, when it comes to caring about the the kids, logic has no place. It's all about her feelings in the moment. If she feels attacked or her role threatened, via DH or I "taking her role" by doing medical care for the kids, or by the possibility of a legal light being shined on her actions, her primary concern is absolutely her own emotional survival at the cost of everyone else's wellbeing. There is no logic involved and again, even though "coordination of insurance to ensure the best coverage for the kids, regardless of under whom they're insured" would logically be in the kids' best interest, it would "dethrone" her and Stepdad as "the providers, the carers, the rescuers" and therefore cannot be tolerated.

...

Anyway. All of your comments were helpful in refining what I think I'm asking, so let me put it together again:

My hope was that given the conflicts we've been through before that have arisen due to Mom paying a medical bill (Mom is primary parent and insurance is through Mom's house) generated from an emergency visit for the kids that DH and I chose, that having 2' insurance would (a) cover the "residual" cost, and therefore (b) eliminate a source of conflict between Mom & DH.

What I think I'm hearing is that it's not a guarantee that the 1' & 2' insurance companies can "figure it out themselves", even if you provide both policies to Urgent Care (for example). You still may have to do the legwork and interact yourself with whoever has the 1' policy. So, while applying 2' insurance to a visit may decrease the $$$ owed, it may increase the contact between parents required.

Is that sounding like others' experiences?

I think what I'm now trying to figure out is: given that 2' insurance for the kids isn't that expensive, I wonder if there's any benefit to "just getting it" -- like, is there a "just in case" reason where it'd be good to have it, but it'd still be fine if we never had to use it. It's not a big $$$ outlay but I'm trying to put together a mental picture of why to get it "just in case". If the kids had a catastrophic or prolonged medical issue, I'm wondering if then the benefit of having more coverage would outweigh the downside of more interaction required between parents.

Thoughts?

[stolencrumbs]

Anyway. All of your comments were helpful in refining what I think I'm asking, so let me put it together again:

My hope was that given the conflicts we've been through before that have arisen due to Mom paying a medical bill (Mom is primary parent and insurance is through Mom's house) generated from an emergency visit for the kids that DH and I chose, that having 2' insurance would (a) cover the "residual" cost, and therefore (b) eliminate a source of conflict between Mom & DH.

What I think I'm hearing is that it's not a guarantee that the 1' & 2' insurance companies can "figure it out themselves", even if you provide both policies to Urgent Care (for example). You still may have to do the legwork and interact yourself with whoever has the 1' policy. So, while applying 2' insurance to a visit may decrease the $$$ owed, it may increase the contact between parents required.

Is that sounding like others' experiences?

I think what I'm now trying to figure out is: given that 2' insurance for the kids isn't that expensive, I wonder if there's any benefit to "just getting it" -- like, is there a "just in case" reason where it'd be good to have it, but it'd still be fine if we never had to use it. It's not a big $$$ outlay but I'm trying to put together a mental picture of why to get it "just in case". If the kids had a catastrophic or prolonged medical issue, I'm wondering if then the benefit of having more coverage would outweigh the downside of more interaction required between parents.

Thoughts?

Yes, it is not a guarantee that the insurance companies will figure it out themselves, but they probably will. The two times I had to get involved with both of the insurance companies was over different classifications the respective insurers used for the same procedure, and that impacted how much each would pay. It was a fairly unique situation. In most normal cases, they should be able to coordinate fine if you are able to file with both insurers.

If it isn't much money, there isn't really any harm in having a secondary insurance policy. You can figure out pretty easily what it will cover for various things. It may or may not cover residual costs for something like an ER visit or urgent care visit. To figure that out, you basically figure out what the primary insurer is going to cover, then apply your secondary insurance to whatever you had to pay in co-pays, deductibles, coinsurance, etc. So if primary insurance has a $150 co-pay for an ER visit, then that's your out-of-pocket cost for that. If your secondary insurance has a $100 co-pay, they're gonna treat you as having a $150 ER visit and apply their coverage to that. So you'd owe $100 and they'd cover $50. So at the end of the day, you'd be out $100 instead of $150. How much of a benefit the secondary policy will be is going to depend on what the coverages are of the different policies. Like, if primary insurance doesn't have a co-pay for ER visits and they are subject to the deductible and coinsurance, but the secondary policy does have a co-pay, that's going to end up saving a lot of money. It could also save a lot of money in the case of some prolonged illness. You would have to meet the deductible for both of them, but once you do, it could cut costs significantly. Say both policies had 80/20 coinsurance. After you meet the deductibles, the primary policy is going to cover 80% of the total costs, and then the secondary policy is going to cover 80% of the coinsurance you paid under the primary policy. So if there was a $10,000 bill, you'd pay $2,000 coinsurance under the primary policy, then the secondary policy would cover 80% of that. You'd be out-of-pocket $200 instead of $2,000. That's at least the way it all worked in my case. Sorry if this doesn't make sense. I wish I had a lot less experience with insurance companies and the healthcare system. 

 

[kells76]

stolencrumbs, thank you so much. This is really helpful. I'll be rereading your post for sure.

Another question hit me on the way to work this morning, and you (and others) may be able to answer this one too...

Am I putting the pieces together correctly here:

Let's say 1' insurance is thru Mom and 2' insurance is through Dad. Dad takes a kid to urgent care and fills out the paperwork appropriately, listing Mom's insurance as 1' and Dad's insurance as 2'.

At that point, can Dad somehow communicate "and please bill my HSA for any further expenses after both 1' & 2' are billed, here is my HSA info"?

Or, does 1' get billed, remainder goes to 2', and then whatever is leftover is on a bill sent to Mom's house?

Is there a way to "head off at the pass" any bill getting sent to Mom -- right away at point of service by saying "bill my HSA for whatever's left"? Or would we have to still go through -- final bill sent to Mom, Mom complains and is passive aggressive and doesn't outright ask us to cover it, lots of drama... ugh.

Trying to understand if it ever works that the final bill is sent to whoever's insurance was billed last, or if the balance always reverts to the 1' insurance holder.

Again, overall goal is a combination of (a) appropriate and timely care for kids, and (b) minimizing open doors for conflict/denigration from Mom.