How do you determine which insurance is primary and which is secondary?

Primary insurance: the insurance that pays first is your “primary” insurance, and this plan will pay up to coverage limits. You may owe cost sharing. Secondary insurance: once your primary insurance has paid its share, the remaining bill goes to your “secondary” insurance, if you have more than one health plan.

What is commercial insurance in medical billing?

For the most part, commercial health insurance is defined as a health insurance plan not administered by the government. You may receive commercial insurance through your employer or your spouse’s employer, or as part of your family’s plan if you meet certain criteria.

How does a copay work with a deductible?

A copay is a common form of cost-sharing under many insurance plans. Copays are a fixed fee you pay when you receive covered care like an office visit or pick up prescription drugs. A deductible is the amount of money you must pay out-of-pocket toward covered benefits before your health insurance company starts paying.

How does a secondary insurance work?

Secondary health insurance is coverage you can buy separately from a medical plan. It helps cover you for care and services that your primary medical plan may not. Some secondary insurance plans may pay you cash. These plans can help pay out-of-pocket health care costs if you get seriously injured or sick.

Is the primary insurance holder responsible for medical bills?

No, parents are not generally responsible for an adult child’s medical debts, said Richard Gundling, senior vice president at the Healthcare Financial Management Association, an organization for finance professionals in health care.

How does copay work with insurance?

A copay (or copayment) is a flat fee that you pay on the spot each time you go to your doctor or fill a prescription. Your copay amount is printed right on your health plan ID card. Copays cover your portion of the cost of a doctor’s visit or medication.

How do copays work with two insurances?

Normally patients that come in with 2 insurances should not be charged a copay. In most cases their secondary policy will pick up the copay left from the primary insurance. We recommend you bill those particular patients after both insurances process the claim for any remaining copay.

What does it mean to have a secondary insurance?

A separate plan that offers additional benefits is called secondary insurance. Your secondary health insurance can be another medical plan, such as through your spouse. More often, it’s a different type of plan you’ve purchased to extend your coverage.