Health Insurance Articles

What Is The Difference Between Primary And Secondary Coverages?

2009-11-11

If you're evaluating your health insurance plan, you may have noticed terms relating to primary and secondary health coverage in your policy. These terms are in every health care policy out there, and they can sometimes seem confusing - especially if you're unfamiliar with health insurance jargon. Primary and secondary coverage are actually quite easy to understand, though. And, they're important terms to know in order to fully grasp what your coverage entails and how your insurance will work if you or a member of your family becomes ill.

The different policy terms related to secondary and primary coverage apply when an insured person is covered under two plans. This is very common for married customers when both partners work at companies that provide health insurance as a benefit. They're both covered under not only their respective employers' health plans, but their spouses' plans as well. A primary plan is the main source of health insurance for a consumer. The secondary plan's coverage is still available to them, but is only used if the primary plan's coverage is exceeded. The primary plan is usually the insurance from a consumer's occupation, and the secondary coverage is from their spouse's policy.

If there were no restrictions like this, being covered under two policies would actually make it profitable for either customer to go to the doctor's office. Their insurers would both pay for each visit, causing a discrepancy of double the cost of a visit. Profits for health insurance customers would be bad for insurers. They'd also be bad for doctors, who would have to deal with a sudden influx of married customers looking to make a profit off of sicknesses. So "primary" and "secondary" plans are necessary to avoid the complications and moral implications of this type of loophole.

Read up on your policy's terms relating to primary and secondary coverage. You may be able to choose which plan you'd like to use as your main insurance coverage, depending on your policy and employer. If you have any questions, it's a good idea to contact a representative of your insurer as quickly as possible to ensure that you're covered in the event of a serious or long-term health problem, either through your primary or secondary insurer. If you don't have secondary insurance, you can ignore the terms that restrict or change coverage based on that insurance (unless you eventually get some form of secondary insurance). Remember that knowledge is important when it comes to health care, so it's certainly worth a bit of your time to occasionally review your policy and make sure that you understand how it will work when you need it.