If you sign up for insurance with your company, You have to indicate who is primary subscriber between yourself and wife. If both a wife and a husband sign up with the same company and both have stated they are primary, Your wasting your money. In the insurance world, secondary insurance was purchased because you want coverage for medical cost and pharmacy cost your primary insurance does not cover. Birthdays having nothing to do with who is first. Indicating on the insurance form as subscriber does.
Often, a person will have "primary" insurance and "secondary" insurance. For example, if you have insurance through your job, and your husband has insurance through his job, then your primary insurance will be the one through your job, and your secondary insurance will be the one through your husband's job. Also, your husband's insurance through his job will be his primary, and yours through your job will be his secondary. There can be some exceptions to this though. For example, if you were married, had a child, then divorced and remarried (retaining custody of the child), and both your ex and current husbands have insurance through work, then the one who's birthday is first is considered the "primary" insurance, and the other is the "secondary" insurance. But there will still be a deductible with each one that has to be met before either one will pay.
In most cases no. You can not chage due to better coverage. 90% of insurance companies, if not more, have what is called a birthday rule. Meaning if you have dependant children on the policy the guardian who was born first (or who is older) is the primary carrier for the dependant children and the younger of the two guardians is the secondary carrier. If you were to have coverage through yourself and a spouse you would be your own primary, as would your spouse be their own primary. If you are the carrier for both insurances then it would all depend on your plan provisions and restrictions, in which case you would have to question each insurance company as to how they would handle determining what insurance is primary and what insurance is secondary.
Your insurance through your employer is your primary insurance, and your spouse's primary insurance is through his/her employer. If both husband and wife are insured on both insurance policies, then you have primary and secondary coverage. But you will still have to pay any deductibles and co-pays before either policy will pay. The deductible is the amount you first have to pay (usually at the first of the year) before the insurance will pay anything. The co-pay is your percentage of what the insurance doesn't pay, which for many health insurance companies is 80% for them and 20% for you. There is sometimes a co-insurance that you have to pay also. Ex: Insurance companies have a set amount that they pay for any office visit, procedure, etc. If the bill is over what the insurance pays, then you are responsible for the balance.
Let me tell you what happend to me. I hope that this helps. I used to be covered by two insurance companies. My primary insurance company was through the company that I worked with. My secondary was with the company that my husband works with. When a claim was filed with my secondary insurance company they wanted to know how much my primary insurance company paid for and until then they would not pay anything. So I had to submit to my primary insurance company and once they paid some then the secondary would. I hope that this helped:) * Yes. A claim must always be made with the primary insurer first.
The birthday rule is often used to determine which plan is primary and which is secondary. Under this rule, the plan of the parent whose birthday occurs first in the calendar year is designated as primary. The date of birth is the determining factor-not the year-so it doesn't matter which spouse is older. Like most rules, the birthday rule has exceptions: * If both parents share the same birthday, the parent who has been covered by his or her plan longest provides the primary coverage for the children. * If one spouse is currently employed and has health insurance through a current employer, and the other spouse has coverage through a former employer (e.g., through COBRA), the plan belonging to the currently employed spouse would be primary. * In the event of divorce or separation, the plan of the parent with custody generally provides primary coverage. If the custodial parent remarries, the new spouse's coverage becomes secondary. And finally, the non-custodial parent's plan would provide a third layer of insurance protection. This order of payment can be altered by a court-issued divorce decree or by agreement, but the insurance companies must be notified.
You do not determine which of your insurance policies are primary in cases where you have multiple health insurance policies. The Federal government passed a law several years ago making Medicare secondary to any other health insurance that you have through an employer or retirement program. This transferred billions of dollars per year from the Medicare and Medicaid programs to private insurance companies all at one time.
Both of you policies will spell out this in the "Co-ordination of Benefits" clause. Most likely the oldest plan will be primary but some go by the birthday of the person insured under the policy. If the retirement benefit coverage is from your spouses policy and the current employer is in your name the birthday may come into effect. Check the COB clause and you will probably find out. If not call the companies.
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