Providers and hospitals that are in your insurance companies network will not come after the patient for costs over the negotiated allowed amount for the services they provide. Providers and hospitals can try to collect from you if they are not in the network (even if your insurance company has paid for some costs) or if some of the services are not covered by your insurance company, or if you are over the benefit limit for those services. Also, providers and hospitals can collect coinsurance costs that you haven't yet paid. If Medicare is secondary than unpaid costs would fall to them but the same rules apply. Potentially some services are not covered by either.
Yes. Check the plan brochure for how much and what percentage.
== == If secondary insurance denies coverage, YOU get to pay the bill. == ==
If the provider is out of network or not contracted with the secondary insurance, they do no have to bill the secondary and the patient is responsible for the balance (if any) owing
Medicare would have covered all the remainder if my insurance had not made the error "Can they rebill medicare again I received a bill from the hospital almost 2 years after spouses death because insurance company made a mistake am I responsible because medicare should pay rest?"
Medicaid is always the payor of last resort. Before a Medicaid agency pays a bill for a Medicare beneficiary, they require documentation that Medicare has "adjudicated" the bill (i.e., decided whether to make payment and, if so, how much).
Blue Cross Blue Shield is primary and Medicare is secondary they will the BCBS first and then bill Medicare.
You submit an EOB from the Medicare HMO with your Medicaid claim.
Yes. Your doctor is not required to file to your secondary insurance.
Yes, under most circumstances it will. Medicare has a set amount for these types of services, no matter what they charge. Medicare allows the provider to bill a certain discounted amount to the patient or insurance company. www.texasbestmedicare.com
You will bill medicare as primary and the supplement secondary. Usually if filing a HCFA 1500 electronically if the supplemental policy is on the beneficiaries Common Working File with Medicare it will automatically crossover to the supplemental policy. Hope this helps....
Medicare does offer coverage for skilled nursing facilties. In order to find out if Medicare will pay as your secondary, the provider needs to submit it to Medicare. This statement is from the Meidcare.gov website: Medicare providers must submit claims (bills) to Medicare for you, whether Medicare is your primary or secondary insurer. For Medicare to process a claim as a secondary payer, the provider must give your primary insurance information to Medicare. You may also consider calling 1-800-Medicare for information about secondary coverage. If you do, remember from Nov 15th to Dec 31st is a busy time for Medicare so it may be difficult to reach them. One more hint to save some frustration: If BlueCross BlueShield has already paid the amount they were supposed to pay, calling them won't really help you because their job is done. Now the remaining bill is between the provider and Medicare.
Yes. If your name is on anything you are jointly responsible for a bill and vice versa.
Once Medicare has "adjudicated" the bill, MediCal's payment will be based on their policy and the patient's eligibility on the date of service.