Secondary coverage is also known as double coverage and results from being covered by two different insurance policies for the same thing. This pretty much only happens in health insurance as no one pays for two homeowner’s policies.

The three most common circumstances that result in double coverage are:

• You purchase a supplemental plan – this is most common with Medicare, and you see AARP and others advertise their supplemental plans all the time. Supplemental plans are never meant to be primary coverage and cost less because they are purchased for the sole purpose of covering expenses the primary insurance does not cover. (Please note: most of what I say is not going to apply to insurance coverage like that provided by Aflac, which is a supplemental insurance, but is enough different that I don’t really know much about it.)
• Two working adults in the family both choose to cover the entire family through their work policies – this is somewhat straight forward if you are one of those adults. Your primary plan is the one through your work and your secondary plan is the one through your spouse. It’s a little more confusing with kids, and you do have to specifically designate which plan is the primary. However, because you are already getting a discount through your work (maybe), and because either plan could be primary and could become primary if the other plan went away, you do not get a discount on the plan that ends up providing the secondary coverage.
• College students who are covered under their parents’ insurance but also purchase coverage through their school. Their parents’ plan is always the primary plan, which is one of the reasons that colleges are generally able to offer coverage (beyond the student health center) for such affordable rates to all of their students.

If you have double coverage, that often means understanding two sets of rules from two different insurance companies. That can be beyond confusing. But here are some basic rules that should hold true regardless of insurance plans.

1)      Most doctors’ offices will only bill your primary insurance. Some might make exceptions for Medicare supplemental plans, but some won’t. There are some Medicare supplemental plans that Medicare will bill directly, but it is a limited number. Also, if you happen to have both plans through the same carrier (say you and your spouse work for the same company), than the insurance company will often bill itself.

But other than those exceptions, expect your medical provider only to bill the primary insurance. You will have to bill the secondary insurance yourself.

2)      Rule one holds true even if you have a deductible on the primary insurance and none on the secondary. You need to pay the deductible.

3)      Your secondary insurance cannot be billed until after your primary insurance has either paid or refused to pay (such as when you have a deductible or received a service not covered by your primary insurance).

4)      Billing your secondary insurance yourself generally requires at least three pieces of paperwork- a claim form from the insurance company, the explanation of benefits from your primary insurance company stating what they have and have not paid, and the bill from your doctor’s office showing what you have paid.

I do not always recommend having secondary coverage. In fact, when C and I were both working, he did not cover me on his insurance, and I did not cover him. Our general medical expenses were not high enough that it was worth double paying for insurance. But in some cases, especially college students who can get the secondary coverage through their school for incredibly low costs, I recommend it highly.

Just remember, you will still likely have to pay out of pocket for what your primary insurance does not cover. And it could be 6 months before you receive any reimbursement, so you have to make sure you have that money available.

If you have any questions about how health insurance works, feel free to leave them in the comments or email me at erinshanendoah@erinshanedoah.com, and I’ll do my best to answer them in a future post.