How does secondary insurance work?


Quick Answer

When a person has more than one health insurance plan, the primary insurance plan makes the first payment, paying until it reaches the limit of coverage before the secondary plan takes over. However, that does not mean the primary insurance always makes the first payment, the Illinois Department of Insurance explains.

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Full Answer

When a person has health insurance from two or more providers, there are a number of factors that determines the primary insurance and secondary insurance. One factor considered is whether the person is the primary subscriber of the insurance plan, or considered a dependant on the plan, the Illinois Department of Insurance notes.

A health insurance plan that provides coverage for an employee, member or subscriber is considered the primary plan over a health plan that covers a person as a dependent or retiree, the Illinois Department of Insurance notes. The plan the insured has had the longest is the primary insurance plan.

In cases such as a no-fault accident, the accident insurance coverage is the primary insurance, while the injured person's health insurance coverage is the secondary insurance plan, the Centers for Medicare & Medicaid Services advises. If a person becomes injured at work, workers' compensation is considered the primary insurance.

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