Health Insurance If both spouses have health insurance which is primary? For spouses with dual health insurance, insurance companies use Coordination of Benefits (COB) to determine which plan is the primary insurance and which is the secondary. Written by: Prachi Singh | Reviewed by: Nupur Gambhir Nupur Gambhir Nupur Gambhir is a content editor and licensed life, health, and disability insurance expert. She has extensive experience bringing brands to life and has built award-nominated campaigns for travel and tech. Her insurance expertise has been featured in Bloomberg News, Forbes Advisor, CNET, Fortune, Slate, Real Simple, Lifehacker, The Financial Gym, and the end-of-life planning service. | Updated on March 17, 2023 Why you should trust Insure.com Quality Verified At Insure.com, we are committed to providing honest and reliable information so that you can make the best financial decisions for you and your family. All of our content is written and reviewed by industry professionals and insurance experts. We maintain strict editorial independence from insurance companies to maintain editorial integrity, so our recommendations are unbiased and are based on a comprehensive list of criteria. In general, when both spouses have insurance plans, your own plan is your primary insurance plan and your spouse’s plan is your secondary insurance plan. If you’re in a situation where both health insurance plans will be used, the insurers coordinate how bills are paid with each other through the “Coordination of Benefits” (COB). COB is a widely practiced industry standard that insurance companies use to determine which plan will pay first and what the second plan will pay. With the benefits of COB and dual health insurance plans, you can save more on out-of-pocket expenses. But at the same time, the added premium payment and deductible might increase your overall health expenses and cause further financial complications. Because of this, it’s important to understand the usefulness of having dual healthcare coverage and make an informed decision accordingly. Dual health insurance coverage for married couples When both spouses have health insurance, they have dual health insurance. It is important to understand which policy is primary and which is secondary in order to file a claim. Read primary vs. secondary coverage for more information. Insurance companies seek aid from the coordination of benefits (COB) to determine which plan will pay first and how much the second plan will pay. However, coordination of benefits can be complicated, especially if you have one type of plan, such as an indemnity plan, and your spouse has an HMO. How COB works under dual health insurance First, the primary plan pays your claims according to the provisions of your policy. If there is a second policy, it will pay for what the primary plan didn’t, but only as long as the medical treatment or services are covered benefits under that plan. For example, if your visit to the doctor costs $60 and your primary plan pays $40 of that, your secondary plan would pay the remaining $20 (if the visit is covered). The plans will not pay more than 100 percent of the cost of treatment, nor will they pay for treatment that isn’t covered. Lastly, dual coverage can be expensive, so be certain that it makes financial sense to pay for both. You don’t want to pay more than you’ll ever get back in benefits by having dual coverage. How do you determine whose insurance is primary? In determining which plan is primary and which is secondary, a plan without a COB provision is generally considered primary. When both plans have COB rules, the plan you are enrolled in as an employee or as the main policyholder is your primary health insurance. The plan in which you are enrolled as a dependent — on your spouse’s plan, for example — is secondary. Contact your insurer or read your policy to determine how your dual coverage works. Related Articles How to add a spouse to your health insurance plan By Huma Naeem Does my deductible start over if I change jobs? By Shivani Gite When does health insurance start at a new job? By Shivani Gite Can I drop my spouse from my health insurance at any time? By Nupur Gambhir When does health insurance expire after leaving your job? By Casey Bond Is health insurance cheaper through work or private? By Cynthia Bowman