Primary v/s Secondary insurances

Primary coverage: When two or more coverage or policies apply to the same loss, the one that pays first, up to its limit of liability or the amount of the loss, whichever is less


Secondary coverage: Coverage that applies only after limits of the primary insurance have been exhausted or denied.

• Which is primary insurance when you and your spouse both have insurance from your employer:

In most cases, the insurance that is provided as a benefit of your primary job is your primary insurance. If you are listed as a dependent on your spouse’s insurance, your spouse’s insurance should be filed as your secondary insurance.

• Which is primary in case of two jobs

In case if you have two jobs and both of your employers have given you insurance, which you consider as your main occupation should be filed as your primary insurance and the other as the secondary insurance.

• Which is primary in case your spouse has employer insurance and you have insurance Medicaid or VA

If you have coverage through Medicaid or VA and your spouse has health insurance coverage through an employer, then your spouse’s policy is primary if primary insurance for you and Medicaid /VA is secondary insurance.

• Birthday Rule:

It is a method of determining which parent's medical coverage is primary for dependent children. Here we need to determine whose birthday comes first when you have two married people with dependents. The child's doctor will bill the primary health insurance provider of the parent whose birthday falls first in a calendar year. For example, one parent's birthday is March 22, and the other parent's birthday is October 10. The March 22 birthday is the primary coverage and the other is secondary coverage.

• Cobra insurance coverage:

Consider which parent has insurance under a current employer if one is retired. Consider which person has been with the same employer the longest when both birthdays fall on the same day. Coverage under a current employer is primary over COBRA insurance coverage. Otherwise, the coverage that started first is the primary insurance coverage when birthdays are the same.