Question

If a person is covered by 2 health policies, one as an employee and one as a dependent, which policy pays first when there is a claim?

a) The employee's policy
b) The dependent's policy
c) Both policies share the cost equally
d) The policy with the higher benefit limit

Answer 1

The policy with the higher benefit limit will usually pay first when there is a claim. The correct answer is option d).

Step-by-step explanation:

If a person is covered by 2 health policies, one as an employee and one as a dependent, the policy with the higher benefit limit will usually pay first when there is a claim. This means that option d) is correct. Let me explain why.

When you have multiple health insurance policies, one policy is considered the primary policy and the other is considered the secondary policy. The primary policy will be responsible for paying the bulk of the claim, up to its benefit limit. The secondary policy will then be responsible for covering any remaining costs, up to its own benefit limit.

For example, if the primary policy has a benefit limit of $10,000 and the secondary policy has a benefit limit of $5,000, the primary policy will pay up to $10,000 and the secondary policy will only pay if there are additional costs beyond $10,000.