What is the role of Primary Insurance?

The role of Primary Insurance is to pay first on a claim. This means that when a healthcare service is provided to a patient who has multiple insurance plans, the primary insurance is the first to process the claim and determine the amount covered. After the primary insurance has paid its share, any remaining balance may then be submitted to a secondary insurer, if applicable.

This prioritization is critical because it establishes the order of payment, helping to streamline the billing process for healthcare providers and ensuring that patients understand their financial responsibilities. The primary insurer is responsible for the initial coverage, and it is this insurer that will pay according to the policy terms before involving any secondary insurance that the patient may hold.

Other options suggest roles that either misrepresent the insurance hierarchy or specify limitations that don’t accurately reflect the broad function of primary insurance. For instance, supplemental coverage refers to additional insurance that helps cover costs not paid by primary insurance. Similarly, covering only emergency services is not a defining characteristic since a primary insurance plan typically covers a range of services beyond emergencies.