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Do you have to pay the medicare deductible if they are paying secondary to a primary insurance carrier?
Wiki User
∙ 13y ago
This is directly from the Medicare and You 2009 Book: When you have other insurance, there are rules that decide whether Medicare or your other insurance pays first. The insurance that pays first is called the "primary payer" and pays up to the limits of its coverage. The one that pays second, called the "secondary payer," only pays if it covers any of the costs left uncovered by the primary coverage. If you have other insurance, tell your doctor, hospital, and pharmacy so your bills get paid correctly. If you have questions about who pays first, or you need to update your other insurance information, call Medicare's Coordination of Benefits Contractor at 1-800-999-1118. TTY users should call 1-800-318-8782. You can view the details here: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf
Wiki User
∙ 15y ago
Wiki User
∙ 13y agoEvery covered life, whether utilizing Medicare as primary or secondary insurance is subject to the same, annual Medicare deductible.
Wiki User
∙ 12y agoNo. If you have a deductible with your primary carrier, you will have to pay the deductible first before Medicare will pay anything.
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How does our acupuncture office get a Medicare denial letter saying that Medicare doesn't pay for acupuncture?
You are correct that Medicare does not cover Acupuncture at this time, and that a "For Denial Purposes Only" letter must be obtained and sent to the secondary insurance carrier as long as the secondary carrier covers Acupuncture performed by a Licensed Acupuncturist in the state where services have been provided.
Insurance carrier that administers Medicare Part a?
The Medicare administrator varies from State to State.
What is Medicare patient's responsibility?
The patients responsibility is the dollar amount indicated on the MRN (Medicare Remittance Notice) due to the doctor (rendering provider). This amount is typically 20% that Medicare does NOT cover, and solely the responsibility of the patient when one has Medicare as their primary health insurance carrier, and NO supplemental or secondary insurance. By law the patient MUST pay this 20% co-pay amount indicated by Medicare. The patients responsibility amount may vary according to the level of visit, or deductible due, all indicated by their insurance. If a Medicare member has any questions regarding how much they owe to a doctor at any time, they should call the number located on the back of their Medicare identification card.
Do you have to have Medicare insurance?
By law, no, but Medicaid and/or your private insurance carrier might insist that you do so.
What is the importance to the practice regarding the 80 20 payment scheme?
Medicare is paying only 80% of the approved amount the patient is being billed. The responsibility for 20% of the Medicare approved amount will be transferred to the secondary insurance carrier.
What is an example of a deductible?
A deductible is your "skin in the game" so to speak. A way of reducing insurance premiums is to increase you're deductible, thereby reducing the risk of the insurance company. If you had an insured loss of $1000 and you had a deductible of $250, you would be paid $750 by your insurance carrier.
Do you contact the at-fault person's insurance or does your agent and if your insurance pays for your damages does his have to pay the deductible?
Quite often, when the other carrier has accepted liability but you have had your damages taken care of by your own carrier, the at-fault carrier will agree to send you your deductible. Any of you can call the at-fault carrier and request this, though they'll need proof from your own carrier as to what the deductible is. If, however, there's a liability dispute between your two carriers, you'll have to wait until your carrier subrogates and/or arbitrates the other carrier. All this means is that your carrier will ask for their money back, including your deductible, and if the other carrier declines, your carrier will initiate arbitration. Your carrier may or may not win; if they do, they get their money back and can send you your deductible.
Do you have to have medicare if you pay your ins?
No, but your private insurance carrier might require you to do so.
If your car is vandalized who pays for the damage?
The vandal if the can be found and sued. Otherwise your insurance if you have full coverage. You will pay a deductible and recover the deductible if the vandal is ever found and successfully sued by your insurance carrier.
Can you be covered by delta dental and aetna dental at the same time?
Yes, you can be covered by multiple dental policies. There will be one insurance carrier as your primary insurance and the second insurance carrier will be your secondary insurance.
Can your insurance carrier raise your deductible without your knowledge?
No, they must inform you of changes to the insurance contract. However, if they sent notice, they will usually have file information on when and where sent.
When should you submit a claim to a secondary insurance company?
After you have received the Explanation Of Benefits (EOB) from your primary carrier if there is coordination of benefits. If the secondary insurance is an indemnity you do not need to wait.
