How secondary insurance works on Headway
We use insurance portals to pull your benefit details and can identify which plan is primary vs. secondary when submitting claims.
If you enter or edit your insurance, and our system detects that a secondary plan was entered as primary, we’ll automatically reorder them to ensure claims are filed correctly — no action needed from you.
You’re always charged based on your primary insurance’s benefit estimate when you have a session. This estimate doesn’t factor in what your secondary plan may cover.
Your secondary insurance provider requires that we submit your primary insurance’s estimate. From there, they’ll determine their coverage based on this. Your secondary insurance might cover some or all of your remaining responsibility, and we'll refund you the difference if that's the case (this can take up to 90 days).
A note on network status and eligibility
In some cases, we can accept your primary insurance but not your secondary plan. You can still move forward with sessions using your primary benefits – however, we won’t be able to file claims with your secondary insurer.
There are also situations where Headway is in-network with your secondary insurance, but your specific provider isn’t credentialed with that plan. If you’d like to use both your primary and secondary insurance benefits, you can enter both plans in the search filters on headway.co to find a provider who accepts both.
Determining which plan is primary and which is secondary
If you have more than one insurance plan active at the same time, one is assigned to be the “primary” plan, and one is assigned to be the “secondary” plan. The primary plan will be responsible for paying your claims first, and your secondary plan will help to cover any leftover amount.
Typically, your insurance carriers and laws governing coordination of benefits will determine which plan is primary and which is secondary.
Don't know which of your insurance plans is primary? Below, several situations are outlined in which primary and secondary plans are pre-determined. We also encourage you to talk with your plan to confirm which plan is primary and which is secondary.
If you are a subscriber on one policy AND are a dependent on a different policy:
| Primary | Secondary |
|---|---|
| The plan on which you are the subscriber. | The plan on which you are a dependent. |
If you are married and are receiving benefits through your employer’s insurance plan AND your spouse’s insurance plan:
| Primary | Secondary |
|---|---|
| This will be your employer’s insurance plan. | This will be your spouse’s insurance plan. |
If you are under 26 and receiving benefits through your parents’ insurance plan AND your school’s insurance plan:
| Primary | Secondary |
|---|---|
| This will be your school’s insurance plan. | This will be your parent’s insurance plan. |
If you are under 26 (with married parents) and are receiving benefits from both parents’ separate plans:
This is commonly known as the “birthday rule.”
| Primary | Secondary |
|---|---|
| This will be the insurance plan of the parent whose birthday comes first in a calendar year. | This will be the insurance plan of the parent whose birthday comes second in a calendar year. |
If you are under 26 (with divorced parents) and are receiving benefits from both parents’ separate plans:
| Primary | Secondary |
|---|---|
| This will be the insurance plan of the parent with custody of the child (if joint custody, the “birthday rule” applies). | This will be the insurance plan of the parent who does not have custody (or “birthday rule” if not applicable). |
If you are married and are receiving benefits from both your spouse’s plan AND your parents’ plan:
| Primary | Secondary |
|---|---|
| This will be your spouse’s insurance plan. | This will be your parent's insurance plan. |
If you have a commercial insurance plan AND Medicaid:
| Primary | Secondary |
|---|---|
| This will be your commercial insurance plan. | This will be your Medicaid insurance plan. |
Unsure of your primary plan?
If you have multiple insurance plans and are still unsure which is your primary, you can reach out directly to either of your insurance carriers for clarity.
Resolving coordination of benefits issues
Clients have to recertify their coordination of benefits (COB) yearly and are the only ones who can do this, providers cannot do this on behalf of a client. The most direct way to update or confirm your COB is to call the insurance number on the back of your ID card.
Pro tip: Use your insurance company's app! If your insurer offers a mobile app, this information is there and they can help you out– often with no call required.
Paused accounts
If your account has been paused, it's because your insurance plan let us know that there’s an issue with your coordination of benefits. You will not be able to continue sessions until this has been resolved.
Unpausing your account
Make sure your insurance plans are entered correctly
Check that the plan listed first on your Headway account is truly your primary insurance.
- If you entered your plans in the wrong order, or listed a secondary plan as primary, update your insurance details on headway.co.
- How to switch your primary plan: Locate the plan that provides your primary coverage in your insurance list. Click the Make primary button next to that plan's details to update the order.
- If you recently got a new primary plan, add it to your account.
If you make these updates within 30 days, your account will automatically unfreeze.
If you're unsure which plan is primary
Call the claims number on the back of your insurance card and ask:
“Is this my primary insurance?”
“Why do I have a claim pending or denied, and how can I fix it?”
“When was my coordination of benefits last updated?”
“Can all pending or denied claims be reprocessed normally?”
They may ask for your date of service, which you can find on your Appointments page. If they update your COB, ask for the call reference number before hanging up.
When you need to contact us to unpause your account
You only need to reach out to us for assistance in unpausing if:
- You missed the 30-day deadline and need us to remove a recoup or manually unfreeze your account
- Your plan on file is your correct primary plan and your account is still frozen
If either of these apply, send us the reference number you received from your insurer so we can help unfreeze your account.