Q: "Why do I have to pay anything out of pocket? I have two health insurance plans. Between them, shouldn't they cover all the costs?"
A: Unfortunately, most insurers changed the rules under which they coordinate benefits within the past 10-15 years. Under the new rules, there's less economic advantage to have two (or more) health insurance plans.
As a general rule, if you have two health plans and you receive both of them on your own (i.e. you don't get either of the plans through your spouse), then generally the plan that you've had for the longest period of time should be the primary policy.
However, there are a lot of variables that can change the result. For example, if one of your plans is Medicare and you get the other plan through your employer, then having a Medicare plan can change the order of benefits, depending on the size of your employer.
Confusing? Yup. If you're having problems with an insurance issue and you live in Washington state, feel free to give us a call. We may be able to help. Our insurance consumer hotline is open from 8 a.m. to 5 p.m., Monday through Friday. The phone number if 1-800-562-6900. You can also reach us at AskMike@oic.wa.gov.