How to Claim Secondary Insurance

Many individuals have more than one health insurance policy, with a second policy acting as a supplementary policy for covering claims not fully covered by the primary insurance policy. Common examples include individuals who are dual eligible for Medicare and Medicaid and individuals who have private insurance along with Medicare. If you have more than one insurance policy, inform all medical providers of all insurance policies and make them aware of which policy is primary and which is secondary.

Instructions

• 1

  Determine which insurance policy is the primary policy. If you have Medicare and Medicaid, Medicare is the primary policy. If you have private insurance and Medicare or Medicaid, the private insurance policy is primary. If neither policy is Medicare or Medicaid, contact both insurance providers to determine which should be billed as primary and secondary.

• 2

  Inform all treatment providers of your insurance policies, and make them aware of which policy is primary and which is secondary. Inform your insurance providers of other coverage that you have that is primary or secondary to the policy.

• 3

  Ensure that your medical provider submits all claims to your primary insurance provider first. In many cases, such as when Medicare is secondary, the primary insurance must deny the claim or refuse to cover the claim in full before it can be reviewed by the secondary insurance provider. The secondary provider typically must receive notice that the claim was submitted and payment was either fully or partially denied with submission of the claim to the secondary provider.

• 4

  Have the medical provider submit the claim to the secondary insurer after a response has been received from the primary insurer.