How terrible an idea is it to sign up for my employer’s HMO while my spouse and kid stay on spouse’s employer PPO plan?
Some background:
Why would I do this? Currently on spouse's PPO plan but it's now OE at my job and the HMO at my work is basically free (No deductible or premiums, low copays) and allows me to keep a very important provider that is no longer in network with spouse's plan (and spouse's plan has no OON coverage)
What's the down side? Now we have to deal with two insurance companies in this house vs just one. Ugh. Also I think if we were to have major medical issues this year (kid is very young, ER visits are not out of the question) then it would make it much harder to hit the OOP max (because I will have a separate max than my spouse and kid).
I don't want to bring spouse and kid onto my HMO because PPO is overall a better plan (No referrals needed, for example) and it would cost about the same whether spouse and kid stay on PPO or both join my HMO.
Another Question that could influence this – If I quit my job mid plan year, does that qualify me to jump back on my spouse's plan? Or would I have to do COBRA until the next OE?
I could also stay on spouse's plan and add this HMO, but not sure which one would be considered primary coverage (I think technically my spouse's plan would be primary for like one month until his OE in Nov, and then his plan would be secondary because they go with the one you were signed up for first?)
In which case…I think my important provider would only be covered once the HMO is the primary coverage because I think the way it works is that if the benefit is covered, the primary coverage rules, even if the specific provider is not in network. Is that right?
So complicated…please help.
submitted by /u/space_to_be_curious
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