Secondary Health Insurance

Secondary health insurance has a number of benefits associated with it. From money saved on expensive procedures to a decreased rate of denials for coverage of any specific medical issue, this is one option that many people cannot afford to ignore.

This type of health coverage is generally optional, and is usually obtained by being listed as a dependent on a spouse’s health insurance policy. With the primary health insurer listed usually being one’s employer, Medicaid, or Medicare, all claims first go through the primary insurance company.

Upon a visit to any physician’s office, one of the required documents requests information about current insurance policies. Listing the primary and both the secondary policy is necessary to ensure that all of the benefits are obtained from both policies, or coverage and premium costs are wasted.

For all types of medical care, whether it is a simple check-up or an intensive care stay in the local hospital, billing goes through a process that is determined by what you write on the insurance documentation you give the provider.

First all bills are submitted to the primary insurance company, which evaluates the case and pays their “allowable” amount. This is then sent to the provider, who updates the information and sends the new billable amount on to the secondary insurance company. This carrier then repeats the process, and any additional expenses are billed to you.

Due to the double coverage, it is extremely rare that a patient with secondary health insurance will be required to pay much when it comes to out-of-pocket expenses, aside from the deductibles that must be met by both policies at the beginning of each year.

In addition, there are often holes in any health insurance policy. While some cover expenses related to vision and dental treatments, others do not. If your primary insurer does not cover these services, you may be able to obtain coverage through your secondary health insurance carrier. With the rising costs of health care not excluding dental and vision treatments, this can amount in a significant savings.

Even individuals that have gone through their health insurance policy with a fine tooth comb may find themselves faced with an unexpected claims denial. If it is believed to be in error, it should be resubmitted or appealed to the primary insurer. However, if it is still determined to be a non-covered medical expense, it may be submitted to the secondary insurance provider, which hopefully will cover the expense. Since you are sending a claim to two different providers, there is an increased chance that one or the other will approve your request.

Most people with Medicare Part A need to purchase secondary health insurance. Since Part A only covers hospital-related expenses, often it is a necessity to find supplemental coverage. While there are a number of companies out there that offer this service, be aware that any that make claims regarding paperwork are not being truthful- only your provider makes the decision as to who completes the paperwork.