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Does new medical insurance coverage automatically become the primary coverage?
Wiki User
∙ 8y ago
No, I'm checking on the CA State Law, but haven't found it yet. Here's the research I found so far.
From Blue Cross Administrators Manual
Medicare is the primary payor for employees age 65 or older in employer groups with less than 20 employees
When a group has fewer than 20 employees, Blue Cross is considered the secondary payor to Medicare and does not duplicate benefits that might be available under Medicare.
This is from Blue Cross of CA FAQ's
What is Coordination of Benefits (COB)?
A43.Coordination of Benefits (COB) is a provision to coordinate 100% of covered charges between multiple group health insurance and to designate the order in which the multiple carriers are to pay benefits. Under a COB provision, one Plan is determined to be primary and its benefits are applied to the claim. Part or all of the unpaid balance is usually paid by the secondary Plan to the limit of its liability. The coordination provisions apply separately to each member, per calendar year, and are largely determined by California law.
Here's the phamplet from Medicare http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf
Wiki User
∙ 8y ago
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What is meant by primary and secondary insurance coverage?
Primary insurance coverage is what is first used when a medical service is being rendered. This is what will be billed first. Secondary insurance is supposed to cover what the primary insurance does not.
Is secondary medical insurance suppose to follow suit of primary coverage?
yes, but it isn't always done automatically. You need to make sure you also follow up.
Can you drop medical coverage for your dependent children when they obtain state Medicaid coverage?
When a non custodial parent is ordered by the court to pay medical coverage, and the custodial parent applies for Medicaid that does not mean that the dependent child's medical coverage can be terminated by the non custodial parent. The ordered insurance becomes the primary insurance, and Medicaid becomes the secondary.
What is the definition of primary coverage in regard to automobile insurance?
Basic coverage.
What is covered on pip insurance in Ohio?
Coverage on PIP insurance in Ohio can be offered by the insurers if PIP insurance is chosen. PIP can may help pay for medical expenses for passengers and the primary driver.
What is a primary policy?
The concept of a "primary policy" can best be understood when there exist two or more insurance policies that arguably provide coverage for the same occurrence. The "primary insurance" is the policy that is first responsible for the payment of claims. A good example might be when a state requires that the owner of a motor vehicle to maintain what of often called "personal injury protection coverage" (a/k/a "no fault coverage"). That type of insurance pays a percentage of the injured insured's medical expenses and/or lost wages regardless of fault for the collision. If the injured insured also has major medical or hospitalization insurance, a primary/secondary insurance scenario develops. State statutory law or interpretative case law will dictate which is primary and which is secondary, but typically, the coverage specific to the occurrence (e.g. the auto-related insurance) will be primary until benefits are exhausted. Primary/secondary insurance situations may also develop when insurance is required to be maintained by the terms of a contract between two or more parties. Often, the contract specifies which (or whose) insurance will be primary.
If you have insurance with your employer and your spouse has insurance on you also which insurance is the primary?
If both you and your spouse have full medical coverage then the insurance compnay will revert back to your and your spouse's date of birth. Whoever's birthdate is first in a calendar year, then that is the primary insurance. For example, if your birthday is November 1, but your spouse's birthday is February 12, then your spouses insurance is primary for both of you.
If primary insurance denies coverage and you have secondary who is responsible to pay the bill?
== == If secondary insurance denies coverage, YOU get to pay the bill. == ==
How do you determine which is the primary and secondary insurer if you and your spouse both have medical insurance coverage?
It goes off the month in which the parent was born! Who ever was born 1st is primary. It does not go off the age!
In an auto accident in California do you bill your auto insurance as the primary insurance or your health insurance?
If you have both medical insurance and auto insurance, the primary company billed will depend on the situation. If your injuries and medical costs were caused by an auto accident and you carry Medical Payments coverage, you will bill your auto insurance provider. If you do not carry Med Pay insurance coverage, as it is optional in the state of California, the circumstances will depend on who is deemed at fault for the accident. If the other party is at fault, you will bill their insurance company and will advise your claims adjuster as well. If you are deemed at fault and do not carry Med Pay, the only insurance you can bill is your medical insurance provider. Be sure your medical insurance provider does not exclude injuries caused in an automobile accident before approving chiropractic care.
What is meant by primary and secondary insurance coverage and what portion of a claim is generalyy paid by each plan?
just read the medical manager and u will find the answer!
If medical insurance will not cover injuries from an auto accident why do they ask if you have it and then limit your coverage?
Medical insurance should cover any injuries substained no matter how they were caused. Health insurance is only responsible (in most cases) for what your car insurance and the third party involved's insurance does not pay. Legally, car insurance is primary over health insurance.
