You're going to have to look at your policy or brochure to see what the provisions are. For more details see www.steveshorr.com/supplemental.htm
Is the patient responsible for deductible and coinsurance if primary insurance paid more than secondary would have allowed.
Yes
Some will. Check with the secondary insurer.
The answer to this question depends on what kind of secondary insurance you have - is it a group health plan? Is it a supplement? If Medicare is primary, there are still deductibles, copays, coinsurance that would need to be satisfied by your secondary insurance. Based on your question, I'm assuming that you have a group health plan with a copayment as your secondary insurance. If so, then yes, you would pay your copayment but it would not exceed the part B deductible.
Yes. For more info. see www.SteveShorr.com/supplemental.htm
Depends on the doctors office billing procedures. For more details visit www.SteveShorr.com yes, your secondary insurance should cover this amount if you have reached your deductible with them. Normally, if the primary insurance applies a deductible or co-insurance/co-pay and you have not met your deductible on your secondary policy, depending on your policy they may apply the remaining balance to your deductible. Normally after the deductible is met on the secondary ins. they pay 100% of your remaining balance.
It's secondary or tertiary insurance that is held to cover any medical expenses the primary insurance policy does not cover or does not cover completely.
A copay is a "set" dollar amount you pay at the time of treatment. For instance, a $35 doctor copay. If you have level one doctor visits, you pay nothing more than the $35 doctor copay. Co-insurance is the percentage you share with the insurance company after your deductible has been met. When you have two policies - your primary insurance will pay first (subject to deductible and co-insurance), and then your second policy starts with the balance left from the primary policy (subject to deductible and co-insurance again). For instance a primary policy with a 5,000 deductible and 80/20 co-insurance of $5000. Your bill for surgery is 6000. You pay 5,000 + 20% of $5000 (1000) = $6000.00 Your balance of your surgery bill is 0
Depending on your coverage, your primary insurance will cover 80% of your charges, minus your deductible (if not already met). Your secondary insurance will pick up the remaining 20% co-insurance and your co-pay, if you have one.
Primary has to process and pay claims first then secondary will process and pay leftover expenses according to their policy provisions. The secondary sometimes excludes payment towards a primary policy deductible.
That is if the secondary does not have a clause in it that "they will not duplicate benefits" If so they will not always pay the difference. They will figure out the amount they would normally pay, subtract what the primary pays from that amount and pay the difference (which with mine is little to nothing and I end up paying the balance of the bill) Nothing really happens, one is the primary and the other is the secondary insurance for the patient. Primary insurance will pay up to 80% of allowed charges if the deductible is met, and the secondary insurance will pay the remaining 20% of the claim, again, if the deductible for the year has been met.
Often, a person will have "primary" insurance and "secondary" insurance. For example, if you have insurance through your job, and your husband has insurance through his job, then your primary insurance will be the one through your job, and your secondary insurance will be the one through your husband's job. Also, your husband's insurance through his job will be his primary, and yours through your job will be his secondary. There can be some exceptions to this though. For example, if you were married, had a child, then divorced and remarried (retaining custody of the child), and both your ex and current husbands have insurance through work, then the one who's birthday is first is considered the "primary" insurance, and the other is the "secondary" insurance. But there will still be a deductible with each one that has to be met before either one will pay.