A Fact Sheet on Findings
How many and what types of children with special health care needs have, in addition to their primary health plan, a second health plan? What services are provided through secondary plans? Is there a relation between having secondary coverage and use of services? Is there a relation between having secondary coverage and parental satisfaction with their child's main health plan?

Methods: Parents were asked if their child has secondary insurance coverage, and if so, who pays for the coverage. They also described what the secondary coverage pays for (in their experience).


  • Almost two-thirds (61%) of the children were covered by one health plan only. A third (34%) also had a secondary plan that was paid for by public funds (such as Medicaid) and a minority (5%) had a secondary plan that was paid for privately.
  • Of those with secondary health plans, parents reported the secondary plan could or was used to pay for the costs of prescription medications (58%); the premiums or deductibles of the child's main health plan (56%); physical, occupational, speech or other therapies (48%), durable medical equipment (46%); inpatient hospital care (38%); disposable medical supplies (37%); outpatient care (36%), home health care (30%); case management services (19%); and/or transportation expenses (18%).
  • Of those who actually received each of the following services, the secondary health plan paid for at least part of the cost: home health care (22%), specialty doctor care (16%), mental health services (12%), prescription medications (15%), physical therapy (10%), occupational therapy (8%), and speech therapy (6%).
  • Parents who have public secondary insurance for their child were more likely to be married and to have higher levels of education than parents with no secondary coverage for their child. No differences between these two groups were observed with respect to income, employment or parental health.
  • Children with public secondary coverage were significantly more likely to have severe and unstable condition(s) and to be in poorer overall health than children with no secondary coverage. However, they were less likely to be member of a racial minority group.
  • Having public secondary coverage was associated with significantly greater receipt of many of the services received by children with special health care needs, including: care from specialty doctors, therapy from physical and occupational therapists, home health services, durable and disposable medications, nutritional counseling, special diets and respite services.
  • Further, having public secondary coverage was associated with more visits to outpatient specialists and more frequent hospitalizations with longer hospital stays. These findings regarding more extensive receipt of services held even when parental socio-demographic characteristics (i.e. marital status, employment, education, income), health status of the child (i.e., severity and stability of child conditions, the overall health of the child) and the child's race were statistically controlled.

Additional information about the survey and its results can be obtained from:

or by contacting:

Nora Wells, Family Voices 1/888-835-5669

Marty Wyngaarden Krauss, Ph.D., Brandeis University