Are there benefits to having both primary and secondary medical coverage?

UPDATED: Jul 24, 2015

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UPDATED: Jul 24, 2015Fact Checked

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Asked July 24, 2015

1 Answer

Used properly, having both a primary and a secondary health insurance plan can save you a lot of money. Only a Health Savings Account will eliminate all out of pocket costs, but having a secondary health insurance policy can reduce the costs by paying for different services or complementing the coverage of the other.

Ideally, the broadest coverage plan is going to be your primary. When you get medical services, the provider will bill your primary insurance policy after you have paid the out of pocket amount, and if the coverage still leaves an unpaid balance, the provider will bill the secondary plan for the remainder. In a situation where the primary policy does not pay for treatment, the secondary policy will be billed, and you will be responsible for any amount it does not cover.

If the two plans overlap, it could create a problem. In a situation where two policies cover the same procedure or services, you run the risk that both insurers will attempt to place the responsibility with the other company. This could actually leave you liable for the initial bill while the insurance companies negotiate who will cover the costs. For this reason, it is important that you purchase a secondary health insurance plan carefully.

Another reason to shop carefully for a secondary health plan is to make sure you have access to the right network of caregivers. For example, it would be easier for you if both policies included the same network of caregivers, allowing you to use the same doctors for all procedures. This may not be possible for everyone, and you may have to do some shopping around to find plans that complement each other in this way.

In a situation where the primary and secondary policies are both associated with a working spouse, the first birthdate of the year will determine which policy is the primary. The age of the policyholder does not matter, but whichever birthdate comes first in the year is the primary by default, and the person whose birthdate comes second will have the secondary policy.

Answered July 31, 2015 by Anonymous

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