When someone has coverage through two health plans, they have “secondary insurance.” One of the health plans is primary health insurance, and the other is secondary health insurance. However, not everyone gets to have both insurance plans.
It is possible only when two health insurance companies collaborate to offer coverage to a person, and it is called the Coordination of Benefits. This process helps avoid unwanted duplicate payments that a person can claim.
However, it will not affect the person with double insurance plans in the case of reimbursements or payments.
The Coordination of Benefits gives the opportunity to cover healthcare expenses by focusing on a better insurance plan to cover the costs. The secondary insurance plan also includes coverage for dental, accident, and vision treatments.
What is the Difference Between Secondary Insurance and Primary Insurance?
The differences between primary and secondary insurance can help provide clear information about the plans. It is also helpful in deciding a suitable healthcare plan.
An individual who is a subscriber, associate, or worker of a group health insurance plan is covered by primary insurance. You will be billed first for primary insurance when you obtain medical attention.
On the other hand, in addition to primary insurance, secondary insurance provides further health coverage for you. For instance, your spouse's health insurance plan would become your secondary insurance if you register for it, even if you already have insurance via your employer.
Secondary insurance is also generally invoiced after your primary insurance has been used up, and it may assist in paying for additional medical expenses.
What are the Benefits of Holding Double Insurance Plans?
Primary insurance cannot cover every medical expense due to the particular obligations under a policy and will not be further applied to cover the additional health costs.
Double insurance plans can help avoid certain charges if one insurance has been completely used. Here are some benefits of holding more than one health insurance plan:
Primary insurance may not cover dental or vision treatments, but secondary insurance can take over the cost.
Physical therapy sessions may be limited under a primary insurance policy, leading to missing doctor-advised additional sessions. Secondary insurance can then cover the additional session costs.
Usually, primary insurance may not fully cover the cost of an operation or severe injuries, so secondary insurance can be helpful. It can also cover cancer care expenses if needed.
Two health insurance policies can together cover unexpected deductibles through copayments.
Who Can Get a Secondary Insurance?
Primary insurance is provided to everyone; however, secondary insurance is only needed by some. Anyone can have a secondary insurance plan, but some cases are prioritized in getting permission for it more than others. But it is beneficial to have a secondary insurance plan.
Here are three brief examples of secondary insurance cases:
1. Adults who are married or live together and are both covered by medical insurance
The spouse or partner can be added to the plan as a dependant if both people are married or in a live-in relationship and have health insurance. This will give them both primary insurance of their own and secondary insurance of their partner or spouse.
2. Minors having parents with health insurance
Parents having health insurance plans can register their children into their own programs. It is like a family health insurance plan.
Insurance providers usually consider the parent with an earlier birth date to be the primary insurance plan holder. In contrast, the parent with a late birthday gets to be the secondary insurance holder of their children.
This is a common practice among insurance firms; however, it is not a registered law or regulation.
3. Health-insured individuals under the age of 26
Any individual, either married, unmarried, or pregnant, and under the age of 26, can be on their parent’s insurance plan as stated by the Affordable Care Act (ACA).
If they have a job, their employers will be the primary insurance providers, while their parents will be considered the secondary insurance providers. These individuals can also gain primary insurance from their schools.
Many more cases can be considered in the case of secondary insurance, such as:
An individual or senior employee with private health insurance and qualifies for Medicaid
A wounded employee with company health plans who is qualified for compensation
Military servicemen and servicewomen with military health coverage and other medical insurance
Can a Person Choose which Should Be their Primary and Secondary Insurance?
A person cannot, in any circumstances, choose their primary and secondary insurance. For example, a person’s employer or organization will always be their primary insurance provider.
However, many people think one can choose their own insurance plan to be primary or secondary for the following reasons. But, in any circumstances, an individual cannot use the following reasons to choose primary or secondary insurance freely because it is not permitted.
Partner or spouse has a more extended and better health coverage plan.
Both parents share the same birthday. If this happens, the insurance provider will go through the insurance holder’s file to determine which one has the most extended health insurance plan and set them as primary.
Parents separated or divorced. In this case, the insurance firm will apply the birthday practice unless one has full custody of the child. However, a judge can rule over this matter to come to a conclusion.
Can a Person Choose which Insurance they Want to Use?
As one cannot choose which insurance plan to make, primary or secondary, an individual cannot also choose which one to use first.
An individual’s primary insurance will always be the first insurance plan to be billed and used when scheduling or acquiring a medical service.