One the surface, primary and secondary health insurance seems like a game of semantics. The differences between these two forms of health care are slight but indelible. Secondary health insurance provides the coverage of a full health care policy while supplemental insurance is intended only to augment an existing primary care plan. Choosing one of these health care routes may come down to finances and the coverage extended through your primary health insurance.
Secondary Insurance
A secondary insurance policy pays the remainder of your health insurance claim after it has passed through your primary insurance provider. This secondary coverage is a standalone policy and could function effectively as your only health insurance policy if you only had one plan. For example, Medicare is usually used as a secondary form of health insurance if you're a senior citizen and have an individual health insurance policy. This is the case because private insurance typically pays more of your health care costs than Medicare. Your government health care is more likely to cover your remaining health care costs than the entire amount it would have to shoulder as your primary health insurance.
Supplementary Insurance
Supplementary, or gap health, insurance provides additional coverage after your health insurance has paid out your claim. A supplemental policy is not a standalone insurance plan and only functions when the policy is attached to existing health insurance. This means a supplemental policy only covers what the primary policy covers. A supplemental insurance policy also has smaller coverage amounts than a primary or secondary insurance plan. It is more likely you will have a remaining balance on your medical bills because of this smaller umbrella of coverage.
The Benefits
Secondary health insurance can cover costs for procedures your primary insurance provider does not cover. This guarantees you a wider array of protection and allows you to tailor each policy to maximize the reduction in your out-of-pocket expenses. Supplemental health insurance costs much less than a secondary insurance policy because it is not intended to be standalone coverage. If you're satisfied with your primary health insurance, a supplemental policy can help reduce your costs from medical bills your primary insurance provider does not completely cover.
The Disadvantages
Supplemental insurance may not cover enough of your health care expenses to justify its cost. Additionally, your coverage limitations may be subject to state and federal coverage regulations if your supplemental health insurance is attached to your Medicare plan. By contrast, a secondary health insurance plan will cover more but you will pay a premium price for that protection. Your primary insurance must also submit the claim to your secondary provider. Any delay in the hand-off could result in your health care provider billing you for the difference in coverage.
References
- Nordian Administrative Services: Supplemental Insurance and Secondary Insurance Differences
- Cal Chiro: Medicare Information Fact Sheet
- National Cancer Institute. “Definition of Supplemental Health Insurance.” Accessed May 19, 2020.
- UnitedHealthcare. "International Travel Insurance Plans." Accessed May 19, 2020.
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- American Income Life Insurance Company. “Accident Insurance vs. Hospital Indemnity Policies: What Is the Difference?” Accessed May 19, 2020.
- eHealth. “Does Dental Insurance Cover Braces and Orthodontist Services?” Accessed May 19, 2020.
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- UnitedHealthCare. ”Coordination of Benefits.” Accessed May 19, 2020.
- HealthCare.gov. “Private Plans Outside the Marketplace Outside Open Enrollment.” Accessed May 19, 2020.
- SHRM. “Voluntary Benefits Now Essential, Not Fringe.” Accessed May 19, 2020.
- Colonial Life. “Critical Illness Insurance Coverage and Policies.” Accessed May 19, 2020.
- UnitedHealthCare. “Accident Insurance.” Accessed May 19, 2020.
- MetLife. “Hospital Indemnity Insurance.” Accessed May 19, 2020.
Writer Bio
Jonathan Lister has been a writer and content marketer since 2003. His latest book publication, "Bullet, a Demos City Novel" is forthcoming from J Taylor Publishing in June 2014. He holds a Bachelor of Arts in English from Shippensburg University and a Master of Fine Arts in writing and poetics from Naropa University.