Travel insurance plans typically cover trip cancellation, trip interruption, medical, baggage, trip delay etc. Depending on the benefit, the coverage may be primary or secondary to any other policy. The most important coverage to consider is the medical coverage, consumers often want to know what it will cover and whether it will be primary or secondary to their current policy.
Difference Between Primary and Secondary Insurance
The primary medical insurance plan will process your claim(s) for payment as if no other insurance plan exists.
The secondary medical insurance policy will process the claim for payment only after they receive an explanation of benefits showing how the primary insurance company processed the claim(s). The secondary medical insurance policy will pick up the patient responsibility assessed by the primary insurance company, i.e., copay, coinsurance etc.
When Secondary Becomes Primary
There are times when a secondary policy will become the primary policy. For example, people who travel to the U.S. and seek travel medical insurance due to the high cost of health care will usually purchase medical insurance policies that are designed to pay secondary. Because no primary insurance policy exists, the secondary policy will pay as primary.
It is important to keep in mind that even if you don't have a primary medical coverage but purchase a secondary travel medical insurance policy, there may be times where another payer will be required to pay as primary. For example:
- You are a passenger in a car and the driver of another car causes an accident resulting in an injury, the medical bills should be processed by both of the drivers car insurance companies and later sent to your medical insurance provider for processing as a secondary payer if any balance is remaining.
- While visiting a mall you slip on a wet floor where no warning sign was posted. You should first file a claim with the malls liability insurance company and if a balance is remaining submit a claim to your insurance company for secondary payment.
There are several benefits to purchasing travel insurance that provides primary medical coverage.
- Travel insurance companies that provide primary medical coverage are more willing to arrange for advance payment if necessary at the foreign hospitals who may not otherwise treat the patients.
- You don't have to worry about filing a claim with other companies or entities for coverage first. You don't have to file 'coordination of benefit' claim forms.
- Travel insurance plans that provide primary medical coverage may not necessarily be significantly more expensive than the ones that provide secondary medical coverage, if at all.
Even if a travel insurance company provides primary medical coverage, some of them may still ask if you have other medical coverage. If you answer 'yes', they may go after that company and try to have the claim processed by them first and merely act as if they provide secondary medical coverage. Therefore, you should simply answer 'No' in such cases.
Medicare does not provide medical coverage outside the U.S. However, for travel insurance purposes, Medicare is still considered the primary medical coverage. Therefore, if you buy travel insurance that offers secondary medical coverage, they would still require you to file a claim with Medicare first. Once you file a claim with Medicare, they will simply decline the coverage and send you a denial letter. You need to submit that denial letter to the travel insurance company before they make any medical coverage payment. If you would like to avoid such hassles and unnecessary steps, you should consider purchasing travel insurance that provides primary medical coverage.
Medigap Medicare Supplement
While Medicare does not provide any coverage outside the U.S., Medigap or Medicare Supplement may provide such coverage. However, it may have a deductible such as $250, with a coinsurance such as 80/20 and usually there is a lifetime limit of $50,000. You will have to keep count of the claims you file as it will be counted towards your lifetime limit. Additionally, it may only provide emergency care for the first 60 days of each trip. If you buy a travel insurance with primary medical coverage, none of this would matter. However, if you buy a travel insurance with secondary medical coverage, you will have to first file a claim with your Medigap or Medicare Supplement insurance.
Primary vs secondary coverage should be considered for other travel insurance coverage such as loss of checked luggage, baggage delay and so on. Many travel insurance companies only provide secondary coverage. That means, you can only claim what you first can't claim from the airline, cruise line, tour operator or your own personal property insurance such as homeowner's insurance or renter's insurance.
When primary medical coverage is not available and secondary medical coverage provides limited coverage, it is possible to purchase multiple secondary coverage policies to increase overall coverage. However, it is not always possible and it requires careful planning by a travel insurance expert. Please contact our office and we would be glad to go over your exact circumstances to see if any such arrangement would be helpful.
Even though travel insurance with primary medical coverage may provide several advantages, that is not always the case. Therefore, it is best to compare various travel insurance plans and decide what would work best for you. Fortunately, you can get instant quotes from various travel insurance companies and make a detailed comparison side by side. For further help, please feel free to contact our office and we would be glad to assist you.