Individuals may be covered under more than one health insurance policy. When this occurs, it is necessary to determine which coverage is primary and which is secondary. Secondary coverage is typically used in situations where the limits of the primary policy have been exhausted.
Whether insurance is considered primary or secondary is significant in determining which insurance coverage applies. This helps to avoid overlapping of benefits, which could result in an insured person being paid twice for the same event.
In the case in which each spouse has a policy at work, the primary coverage for each would normally come from their respective employer. A spouse may also be listed as a dependent on the other's work policy.
An individual employment-based policy does not always make it the primary coverage. For example, if a woman were covered by her husband's work policy for a longer period than from a policy from her employer, the husband's policy would typically be considered as primary.
Disputes sometimes arise when determining which coverage should be considered primary. To help avoid disputes, insurance companies typically include provisions in their policies that help policyholders distinguish between primary and secondary coverage.
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