If I also have other insurance
Benefi works alongside a spouse's plan or marketplace coverage.
You can use Benefi alongside other insurance without any conflict. Think of Benefi as your first stop for everyday healthcare needs, while other coverage handles situations Benefi doesn't cover.
Using Benefi with a spouse's or partner's plan
If you're covered under your spouse or partner's major medical plan, you have two complementary options. Use Benefi for your routine care needs like Virtual Primary Care visits, mental health therapy sessions, and $0 prescriptions. When you need services Benefi doesn't cover (like hospital stays, surgery, or specialist care beyond your Plus plan allowance), use your spouse's plan.
This dual coverage can save you money. A virtual doctor visit through Benefi costs $0, while the same visit might have a copay on your spouse's plan. Your Benefi formulary medications are $0, compared to potentially higher costs through major medical.
Benefi and marketplace plans
The same principle applies if you have an individual marketplace plan. Use Benefi for:
Best uses for each plan
- Benefi first: Virtual doctor visits, common prescriptions, preventive care
- Marketplace for: Emergency room visits, surgery, ongoing specialist care
- Compare costs: Check both plans' coverage for each service you need
Your marketplace plan likely has deductibles and copays that make routine care expensive. Benefi fills that gap with $0 virtual visits and covered medications.
Special situations
Medicare eligibility (age 65+): Benefi is typically not offered to Medicare-eligible employees. Your employer's HR team can explain what benefits are available to you once you qualify for Medicare.
Medicaid coverage: If you qualify for Medicaid, review what it covers in your state. Medicaid often provides comprehensive coverage at little to no cost. You can still access Benefi through your employer for services like 24/7 Virtual Primary Care that might have wait times through Medicaid.
How benefits work together
Benefi doesn't coordinate benefits with other insurance plans. Each plan processes claims independently. When you need care, choose the plan that offers the best coverage for that specific service. There's no need to notify either plan about the other, and having both doesn't affect your eligibility or coverage levels.
Remember: Benefi is a MEC plan designed for routine and preventive care. It doesn't cover hospitalization, surgery, or emergency room visits. Keep your other coverage active for these major medical needs.