What is secondary insurance?

Secondary insurance occurs when a person is covered under two health plans; one plan will be designated as the primary health insurance plan and the other will be called the secondary insurance. The primary insurance is where health claims are submitted first. The secondary insurance will then pay the remaining costs eligible for coverage under their health plan.

When two health insurance providers work together in this way to provide coverage, it is called coordination of benefits. Insurance providers can avoid double payment for claims this way. This does not mean you get double payment or reimbursement; however, if one plan has better coverage for a service than another plan, it can help cover health care costs.

Supplemental insurance, such as vision, dental or accident coverage, is also sometimes called secondary insurance.

Who can take secondary insurance?

There are no eligibility requirements for who can take out secondary insurance, but there are three cases in which it is most common:

• Underage children whose both parents have health insurance:  Both parents can enroll their children in their health insurance plans. Generally, the plan of the parent whose birthday is earlier in the calendar year is designated as the primary insurance plan, and the plan of the parent with the later birthday becomes the secondary insurance plan. This is also known as the birthday rule (although it is not a law, but a best practice among insurers).
• Adults under age 26 who have health insurance:   Under  the Affordable Care Act (ACA) , unmarried and married children can stay on their parents' insurance until age 26. These individuals may also be covered through a school or employer health insurance plan. Their workplace or school plan will be their primary insurance and their parents' plan will be secondary insurance.
• Married adults or domestic partners who have health insurance:  If both people in a marriage or domestic partnership have health insurance, they can add their spouse or partner to their plan as a dependent and then that spouse or partner will have both primary insurance (their own) and secondary insurance (their spouse or partner's plan).

Can you choose which plan is primary and which is secondary?

The short answer is no, you can't. As noted above, a person's employer-sponsored plan will always be the primary one. Even if a spouse or parent's plan has better coverage or perhaps a lower deductible, you cannot submit claims to them first.

In case of a minor child, if both the parents have the same birthday or they are divorced, then also the person covered under the scheme will not have the right to opt for it.

• If both parents have the same birthday, the plan that covers one parent for the longest period will be the primary one.
• If the parents are divorced or separated, the birthday rule will apply unless it is removed by a judge or divorce order. Otherwise, the plan of the parent who has custody of the child will be considered primary.