Secondary insurance is a policy that provides coverage in addition to primary insurance, usually when the primary policy does not cover a specific type of medical expense. Secondary insurance is important for patients because it can help cover expenses not covered by their primary policy, like dental and vision care.
When Should Primary Insurance Be contacted?
Primary insurance should always be contacted when a patient first receives treatment in order to ensure that their policy is valid and covers the necessary services. However, there are certain instances when the secondary insurance should also be contacted.
For example, if a patient is receiving long-term care or in a rehabilitation facility, their secondary insurance may cover their care. In addition, if a patient has multiple policies and one of them does not cover the services they need, the secondary insurance may be able to help cover those costs.
What is Secondary Insurance?
Secondary insurance is a type of insurance that covers benefits that are not directly provided by your primary insurance. For example, if you have health insurance through your employer, your secondary insurance may cover medical expenses not covered by your employer’s plan. Secondary insurance can also provide coverage for things like accidental death and dismemberment, which are not typically covered by standard health insurance policies.
Many people use secondary insurance to cover expenses not covered by their regular health insurance policy, or to cover costs that their regular policy does not cover. For example, a person who has health coverage through their job may have secondary insurance that covers medical expenses not covered by the employer’s plan.
When can a patient’s secondary insurance be billed?
The answer to this question depends on the specific policy you have. However, in general, most secondary policies will allow coverage to be billed as soon as the related events occur. This means that you may be able to receive payment for medical expenses right away, rather than having to wait until your claim is processed.
It is important to note that not all secondary policies are the same. Some may require more processing time before payments are made, while others may pay out immediately.
Types of Secondary Insurance
When you have a health insurance policy, it is important to read the terms and conditions of the policy so that you are aware of any exclusions or limitations that may apply. In some cases, your health insurance policy may exclude coverage for services that you receive through a secondary insurance plan. If you are covered under your health insurance policy, but your secondary insurance plan does not cover certain services, then you may be able to find a third-party payer to cover the costs.
Who is Eligible for Secondary Insurance?
Secondary insurance is a type of insurance that is typically used to cover expenses not covered by regular healthcare insurance. Patients who are eligible for secondary insurance can include those who are unable to find affordable coverage through their employer, those with pre-existing medical conditions, and those with low incomes.
The healthcare reform law passed in 2010 included a provision that allowed patients to keep their existing health insurance policy if it met certain requirements. This means that most patients who are eligible for secondary insurance should be able to continue using their policy without any changes. However, there are a few exceptions. If your health insurer is canceling your policy because of the new law, you may need to switch to a new policy that meets the requirements of the reform law.
If you have questions about whether your policy is still valid under the new law, contact your insurance company or speak with a healthcare lawyer.
How to Request Secondary Insurance be Billed
When a patient is admitted to the hospital, their insurance company may already be aware of their condition and be in the process of settling their claim. If this is the case, the insurance company may not require any documentation from the hospital before issuing a reimbursement.
If the patient does not have any insurance or if their insurance does not cover their condition, the hospital may require documentation from the patient’s primary care physician or specialist in order to determine whether the insurance company should be billed. In some cases, the insurance company may require a complete medical record before approving a reimbursement.
Conclusion
As a healthcare provider, it’s always important to be aware of which secondary insurance policies your patients have. Whether they are covered under their employer’s health plan or through a separate policy, knowing which ones will cover your services is important information. If you’re not sure whether a patient has secondary insurance coverage, ask them directly. Additionally, keep a copy of their insurance coverage handy in the event that there are any questions about billing later on.
