Final answer:
When covered by two health plans, a primary and a secondary payer, the primary covers initial costs, and the secondary may cover remaining costs like copayments and coinsurance, depending on the specifics of the plans.
Step-by-step explanation:
When a patient is covered by two health insurance plans, primary payer and secondary payer plans come into effect. The primary payer is the insurance that pays first and covers the standard benefits as if it were the only source of health coverage. The secondary payer covers some or all of the remaining costs after the primary payer has paid its share. This can include copayments, coinsurance, and deductibles. For example, if the primary insurance covers 80% of a medical bill, the secondary insurance may cover the remaining 20%, or part of it, taking into account the plan's specific rules and coverage agreements.
U.S. healthcare coverage typically falls under two main categories: public healthcare, which is government-funded, and private healthcare, which is privately funded. Employment-based insurance, part of the private healthcare system, is provided by an employer or union, while direct-purchase insurance is obtained directly by an individual from a private company.
Moreover, Part B is a component of public healthcare where participants pay a monthly fee, deductible charges, and copayments for health-care costs outside hospital stays, such as physician services and outpatient visits. The government subsidizes approximately 75% of the costs of this optional insurance system.