Newbie to dual insurance. I'm covered through my spouse's insurance, which he gets through his work. I will be changing to a new policy (still through his work) whose deductible is $500 and out of pocket max is $2000. I'm trying to get a certain surgery done, so I changed to this insurance in hopes that it should be covered. This will be effective January.

I just started a new job and found that they offer the lowest "tier" of their employee health insurance plan for FREE. There is no deductible but out of pocket max is $5400. The benefits look pretty good, but caveat is that the providers I can see in this lowest tier are very limited and only a few hospitals are covered. For example, my current PCP, OB, and dermatologist are not in-network. The only reason I'd want this insurance is in case I need to go to the nearest ER/hospital, which is completely covered.

If I choose to add my job's health insurance, I believe this will be my primary insurance, while my spouse's will be my secondary? So my primary will be billed first.

How does the out of pocket max work with dual insurance – will mine be $7400 ($2000 + $5400)? The main thing stopping me is that my out of pocket would be so much higher with both, because I will definitely reach this after getting my surgery. If I do have a higher out of pocket, is it even worth to add my job's insurance if the only real use I have for it is a potential ER/hospital visit? I want to keep my same PCP, OB, and derm.

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They are also both PPOs if that makes any difference. Thanks.

submitted by /u/captbunbun
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