Should I Consider Getting Secondary Health Insurance?
 Written by Derek San Filippo Derek San FilippoDerek is a former staff writer and has written 100+ articles on property & casualty, health and life insurance topics as... Read more |  Edited by Dan MarticioDan MarticioDan Marticio is the content manager at SmartFinancial and has written 150+ articles across multiple insurance verticals.... Read more |
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Secondary insurance refers to a separate but supplemental policy that can cover some of the gaps in your primary health insurance plan. In terms of payment order, your primary provider will be billed first and your secondary provider will pay toward the remaining balance.
Read about the different kinds of secondary health insurance.
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Key Takeaways
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What Is Secondary Health Insurance?
Secondary health insurance is a supplemental policy that covers medical expenses not paid by your primary insurance. This can include coverage for excluded benefits such as dental and vision, as well as payment toward deductibles, copays and other out-of-pocket costs. In addition, you may be able to see a provider that you like that is excluded in your primary policy’s network but is inside your secondary policy’s network.
How Does Secondary Insurance Work?
If you have two health insurance policies that cover the same types of healthcare services, a process called coordination of benefits will determine who pays first. Your policy may already spell out which company is the first payor but you can ask your carrier if you’re unsure. For example, if you’re a Medicare recipient age 65 or older, Medicare may pay first or second depending on the type of secondary insurance you have.[1]
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Secondary Insurance |
Does Medicare Pay First or Second? |
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Retiree insurance from your former employer |
Medicare pays first |
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Group health insurance through your spouse’s current employer + employer has 20 or more employees |
Medicare pays second |
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Group health insurance through your spouse’s current employer + employer has fewer than 20 employees |
Medicare pays first |
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Group health insurance through a family member’s current employer + you have a disability + the employer has fewer than 100 employees |
Medicare pays second |
Whichever carrier that pays the medical bill first should send you an Explanation of Benefits (EOB) statement that outlines what was paid and the remaining balance. You can then submit this EOB statement to your secondary insurance and they will pay toward eligible expenses up to that policy’s limits. Any amount remaining will have to be paid out of pocket by you.
In addition, secondary insurance can cover services and expenses entirely excluded from your primary policy. Dental and vision insurance are common types of secondary insurance because dental cleanings, eye exams and other related services are usually not included in your primary health insurance. Meanwhile, a type of secondary insurance called Medigap covers out-of-pocket costs for Medicare beneficiaries such as deductibles, copays and coinsurance.
What Types of Secondary Coverages Can You Get?
Secondary insurance includes a range of insurance plans that complement primary insurance coverage. Some plans may pair well with high-deductible plans while others pay toward expenses not covered by the primary policy such as vision or dental services.
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Secondary Insurance |
Description |
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Provides death, dismemberment and disability benefits and reimburses for medical expenses when an accident causes injury, disability or death |
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Pays a predetermined lump sum to be used toward eligible expenses when the policyholder is diagnosed with a chronic illness such as cancer or suffers a heart attack or stroke |
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Dental Insurance |
Covers dental visits, preventive care and significant dental services or orthodontia |
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Vision Insurance |
Covers eye care expenses like exams and eyewear |
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Disability Insurance |
Replaces a portion of the income of a disabled person who cannot work on a short- or long-term basis depending on the severity |
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Gap Health Insurance |
Provides a lump-sum payment for covered ailments, offsetting out-of-pocket expenses |
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Medigap |
Pays for certain expenses not covered by Original Medicare including deductibles, copayments and coinsurance. |
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Provides prescription drug coverage for Medicare beneficiaries |
Can the VA Be a Secondary Insurance Provider?
Veterans can get healthcare coverage through the U.S. Department of Veterans Affairs (VA), which can be a secondary insurance provider if you already have a primary health insurance plan.[2] The VA can coordinate with your primary insurance to cover gaps in your healthcare costs.
How Much Does Secondary Insurance Cost?
Since there are so many different types of secondary insurance plans, the cost of a secondary insurance plan will depend on which one you choose. For instance, the cost of a Medicare supplement plan (Medigap) is around $150 per month, while the average cost for dental coverage is between $20 to $50 for an individual plan.[3][4] A group family health insurance plan alone is over $1,800 per month.[5]
Who Can Have Secondary Health Insurance?
Here are some groups of people who can have secondary medical insurance:
- Individuals with private health insurance: Private plans are purchased through the health insurance marketplace or directly from healthcare companies.
- Spouses who are each insured through their employer: Spouses with group health insurance through their employers can use their spouse’s coverage as secondary insurance. Coverage through your employer will be primary and your spouse’s coverage will be the secondary payor so long as you’re a named insured on their policy.
- Underage children when both parents are separately insured: The policy of the parent whose birthday comes first in a calendar year will function as primary coverage for the child. Meanwhile, the other spouse’s health insurance policy can be secondary coverage.
- Adults under age 26: Those under 26 who are still on their parent's health plan can get secondary coverage through work or school.
- Medicare beneficiaries: Medicare beneficiaries may opt for secondary health insurance coverage known as Medigap, which pays for out-of-pocket costs like deductibles and copays.
- Medicaid recipients: In some cases, individuals eligible for Medicaid may have secondary health insurance through Medicare.
How Do I Choose the Best Secondary Health Insurance Plan?
The type of secondary plan that offers the most value for you will depend on your lifestyle and whether your primary plan covers services you need. For example, individuals who work dangerous jobs should consider accidental death & dismemberment insurance in case they suffer a debilitating workplace injury. Meanwhile, vision insurance — often excluded in health insurance policies — is a good idea for individuals who need prescription glasses or contact lens refills.
Once you identify what you need, it’s time to compare the coverage and cost options offered by different secondary insurance providers. As you evaluate the cost of premiums, deductibles and copayments, consider your budget and determine what level of financial protection is affordable for you. Also, check if your preferred healthcare providers are included in the plan's network, as this can significantly impact your access to care.
It's also worth considering customer reviews and the plan's additional benefits. If you find the decision overwhelming or need further guidance, consult with an insurance broker or use an insurance marketplace like SmartFinancial to ask questions from a healthcare insurance professional and get a free quote.
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- Secondary Health Insurance
Derek is a former staff writer and has written 100+ articles on property & casualty, health and life insurance topics as an insurance expert for SmartFinancial. Within his decade-long career writing about finances, entertainment, religion and philosophy, Derek spent three years writing financial articles for credit unions throughout the U.S. He prides himself on his ability to translate complex topics into actionable tips for everyday people.
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