Tertiary Insurance | Every Things You Need to Know

Tertiary insurance is the third type of insurance. Liability insurance is the fourth type of insurance. In some cases, like if you have Medicare and supplemental insurance, you may have more than one policy covering a specific procedure or claims, so you may have more than one policy that pays for it.

 There are three types of insurance that people must pay. The third one is the third-party option, which you add to your other two tiers of insurance. It’s also an “all contingency” insurance because it covers expensive or unusual claims.

It’s usually part of health insurance, but it can also be part of other types of insurance, like life insurance or auto insurance.

Third-party: The term “tertiary” means “third party.” Thus, tertiary insurance protects the person with primary and secondary insurance.

It works with two other insurance companies to “coordinate” claims, which means they figure out which company will pay what part of the claim and which company will spend the rest.

Insurance companies need to agree on who is responsible for claims when they cover the same thing.

People who have health insurance with their spouses will agree that this is true if two different insurers pay for the child’s medical expenses and have family health coverage.

How Tertiary Insurance Works

Tertiary Insurance

You can only get level 3 insurance if your primary and secondary insurance is insufficient. You might need Level 3 insurance if you have a claim for $150,000, but your primary and secondary insurance only covers $100,000 each.

So, if you have three policies, the bill will always go to the first one. If there is a balance, it goes to the second insurance company, and they pay it. They finally send it to the third insurance company, which will pay for the rest.

If you have two insurance companies and you have a claim, one of them should be the primary one, and the other should be the secondary one, like this:

  • Secondary insurance pays for costs that the primary insurer doesn’t cover if the secondary insurer does cover them but not the primary insurer. This is “double insurance.”
  • The third level of insurance is the “third tier” or “supplemental tier,” It covers more things that happen. In many cases, this is a benefit that workers get from their own or their family’s leading health insurance plan.

Importance of Tertiary Insurance

Tertiary Insurance

Many people think they don’t need liability insurance because most people already have primary and supplemental insurance. However, it’s essential to know that insurance doesn’t handle all of the things that happen in your life. Both types of insurance may not be enough to cover a claim if there are exceptions or very little insurance.

So, liability insurance can be beneficial in these cases.

Covering Excess Costs

Tertiary insurance is a backup plan in case primary and secondary insurance doesn’t cover the total cost of a claim, so it comes in.

For example, if you have health insurance, you might need a costly operation that other insurers won’t pay for, so you might have to pay for it yourself.

Your liability insurance is only as good as the limits of both your primary and secondary coverage’s. As long as you have such a service, this is also possible. If you buy insurance from someone else, you can write off the money you pay out of pocket.

Order of Coverage’s

Laws and federal law set the rules for liability insurance. Insurers are liable to third parties based on these rules. For example, if a retiree has Medicare, they can buy supplemental insurance, always the second type. If the person is eligible for the Medicaid program, this option is called third-party insurance. It pays for what the basic and secondary insurance does not cover.

When Coverage Kicks In

If your primary and secondary coverage is not enough, third-party coverage comes into play.

Suppose you’ve got a $100,000 claim and your first two insurance policies cover $150,000. Third-party insurance doesn’t cover that claim because your first two policies cover that amount. This doesn’t mean that the company agrees to “split the bill in half,” but it does.

The primary insurance company will always get the bill first. If there’s still money after the first insurer pays it, the second insurer gets it. The third insurance company gets the rest.


  • He might also become a “third-party beneficiary” of a life insurance plan.
  • When you get a life insurance policy, you’ve got to pick a person who will earn money from your estate if you die. You’ve got to name this person as your beneficiary.
  • You can also name a second or third beneficiary. Primary beneficiaries die before they pay them their death benefits. The third beneficiary then becomes the primary beneficiary and gets the money first.
  • The third beneficiary can also be a person who gets one-third of the money from the money. In this case, only if you have named above one beneficiary on the policy.

Tertiary Tangles

Claiming liability insurance can be a complicated thing to do.

Medical billing companies have to classify claims, but insurance companies often don’t pay them, especially when it comes to liability issues, which is why they often don’t pay them (e.g., workplace accidents or car accidents).

When a doctor wants to sue a liability insurance company, a judge must decide the case.

Getting Tertiary Insurance

Since Level 3 insurance doesn’t start until after the benefits of level 1 and level 2 insurance have been used, Level 3 premiums can be very cheap. People who work for an employer can also get Level 3 insurance as part of a pay package.

Depending on your eligibility, you may be able to move Medicare or Veteran’s health insurance to Level 2 or 3 for people who have employment-related coverage. If you have a credit card or bank account, you may get other types of liability insurance from the company. 

Frequently Asked Question

How Do I Bill A Tertiary request?                 

There are a lot of ways to change a liability insurance request. They are.

One way to do this is to change the third-party insurance information in the extra insurance step. Then, when you get the claim from a third party, you can get it through a secondary insurance claim.

You can make a paper claim and then get it in the mail.

What Happens When Medicare Forwards A Claim To The Secondary Insurance?

A “secondary insurance claim” is when Medicaid submits a claim to some other insurer.

The secondary payer is the firm that receives a claim from Medicare and transfers it to another insurer. The secondary payer settles the claim for the primary payer if the first payer does not pay the share.

What Does Tertiary Payer Mean?

Third-party payer: Medicare becomes a third-party payer if a beneficiary has more than one central insurance policy. The first person to pay the claim is always the primary payer.

How Do You Bill Medicare Tertiary Requests?

Make sure to follow the steps below to make a Level 3 Medicare claim.

  • You must send the claim online because Medicare is your primary payer.
  • 2. Your request is denied; you must send in a form that has been filled out and payment statements from both primary payers.

How Are Primary and Secondary Insurance Determined?

People who pay out claims first are called “primary insurers.” Losses are paid by this system up to a certain amount. The primary insurer has already paid the full amount of the claim, and now it’s time for you to deal with your secondary insurance company.

Do Providers Need Bill Secondary Insurance?

The provider must send you an invoice to know your secondary insurance company. A patient must get a portion of the bill to send it in for reimbursement.

Can 2 Insurances cover you?

Yes, its possible to get insurance from two different places. For instance, you could obtain two health coverage policies. That’s legal, and you can do it. If you have more than one policy, you might have more than one.

What Is Tertiary Care’s Principal Aim?

The three main forms of health care are secondary, primary, and tertiary care. Only overall medical care is the focus of primary care. Tertiary and secondary care are for ailments that require more highly specialized and rigorous treatment.

Bottom line

A tertiary insurance plan can come from having health insurance for many different jobs, leading to it.

Suppose one spouse works at a company and it has coverage. In that case, the other spouse works at another company, gets retirement insurance from their previous employer, moves to another company, and then gets new health insurance at a new company, too. Sometimes it can be good to have more than one policy because one policy might cover things the other doesn’t.

Most of the time, the primary policy covers a certain amount, and the supplemental policy covers extra costs. However, if, for some reason, the leading insurance doesn’t cover these costs, the additional insurance will pay for them, as well!

People who work for many businesses get third-party insurance as part of their pay. You can also buy more insurance from your credit card company, bank, or other company that may offer insurance as part of a package.


Adam Grabois is an expert in all aspects of Insurance and Property with 20 years of experience. He is a licensed broker of all lines including property, casualty, life, and health. As a licensed adjuster, he is well-versed in all aspects of insurance, and he owns All Needs Insurance agency in Florida.

He attended Tufts University where he earned his undergraduate degree, followed by a Master's degree from Columbia University.

Adam shares his breadth of experience by helping many businesses and individuals manage risk and protect themselves financially. He now shares this with the audience of the "Pro Insurance Info" website.

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