Secondary payer

A secondary payer in healthcare refers to an insurance plan or program that covers medical costs after the primary insurance has made its payments. This typically occurs when an individual has more than one insurance plan, such as Medicare and a private insurance policy, or when certain types of insurance have overlapping coverage, like workers’ compensation and group health insurance. The secondary payer steps in to cover costs that are not paid by the primary insurer, reducing the out-of-pocket expenses for the insured individual. Coordination between primary and secondary payers is essential to ensure that medical expenses are appropriately covered and that claims are processed efficiently.