If you have more than one kind of health insurance, one will be considered primary, and the others will be secondary. These designations determine what bills each health insurance policy will cover. It also determines which insurance company will be sent the bill when you visit a doctor or receive hospital care.
Health insurance that comes from your employer is, in most cases, your primary care insurance. Why? This is because it covers both you and your spouse, or, because it is the health insurance policy that you have had for the longest amount of time. There are a lot of people who do not have any kind of health insurance until they become employed with a company or corporation that is able to offer it to them. Primary insurance is often the health insurance policy that you got first, instead of the ones you may have gotten later, in addition to this first form of health insurance. Your primary health care insurance is your main source of health care insurance.
Secondary health insurance, on the other hand, consists of whatever other forms of health insurance you have, (not including your primary insurance). For example, if your job gives you access to health insurance, and your spouse’s job does as well, a decision needs to be made about which one will become the primary insurance. If you, or a member of your family, qualifies for Medicaid, Medicare, or another form of government run health insurance, this health insurance will be your secondary health insurance.
Ideally, when you visit a doctor, or receive health care from a hospital, (or other care facility), the medical bills will first be sent to your primary health insurance company. This form of health insurance might cover all of the bills, some of the bills, or none of the bills. If the bills have not been paid in full by your primary insurance company, it gets sent to your secondary insurance company. The secondary insurance company will decide how much of the remaining bills it will cover. If the secondary insurance company does not pay the remaining amount of the bills in full, it will become your responsibility to pay the remaining amount.
Keep in mind that this is the way it would work if everything went exactly as it was intended to. Often, the system doesn’t run this smoothly. In reality, it isn’t always easy to know which bill got sent to which health insurance company, and to remember what each is supposed to cover. This can result in confusion as you try and sort everything out. This complex system was originally designed to spare the insurance companies the expense of paying for a bill that has already been paid for, and to prevent consumers from being able to make a profit by visiting a doctor.
Image by Tracy O on Flickr