Primary payer
When you have more than one insurance plan, the one that pays first.
When a patient has multiple insurance plans (e.g., employer + spouse's employer, Medicare + Medigap, employer + Tricare), one plan is primary and pays first. Federal rules and the 'birthday rule' (for child coverage) determine which is primary. The secondary payer adjudicates after the primary, accounting for what the primary paid.
Frequently asked questions
What is primary payer?
When a patient has multiple insurance plans (e.g., employer + spouse's employer, Medicare + Medigap, employer + Tricare), one plan is primary and pays first. Federal rules and the 'birthday rule' (for child coverage) determine which is primary. The secondary payer adjudicates after the primary, accounting for what the primary paid.
Related terms
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