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Does new medical insurance coverage automatically become the primary coverage?

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Wiki User
2015-07-15 18:38:38
2015-07-15 18:38:38

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

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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.

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yes, but it isn't always done automatically. You need to make sure you also follow up.

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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.

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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.

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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.

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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.

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== == If secondary insurance denies coverage, YOU get to pay the bill. == ==

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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.

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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!

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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.

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1. Most states have a requirement that a registrant of an auto maintain "personal injury protection" (PIP) coverage (altho the name may be different). This is the essence of so-called no-fault auto insurance. Essentially, it pays a percentage of the insured's own medical bills and lost wages, up to a maximum amount, arising from an auto collision. It pays those expenses irrespective of fault for the collision. 2. Most insurers also offer a Medical Payments coverage. This is often an optional coverage. It pays an additional amount toward medical expenses , and often coordinates with the PIP coverage. Therefore, if the PIP coverage pays 80% of the medical bills, up to the policy limits, the medical payments coverage will pay the remaining 20% up to its policy limits. 3. If medical expenses exceed #1 and #2, one's major medical insurance is triggered. The auto insurance is "primary" in the sense that its benefits have to be exhausted before major medical insurance is called upon to pay. This is because auto insurance is required by state "financial responsibility laws" and for the further reason that it and the major medical insurance contain "coordination of benefits" provisions making the auto insurance primary. 4. If medical expenses still exceed the total available auto insurance and major medical insurance (including, if there is no major medical insurance), the injured party/insured is personally responsible for unpaid amounts. In this situation, the health care provider frequently is willing to work out payment arrangements. Alternatively, the unpaid amounts may be discharged in bankruptcy, but this is a very drastic step and should be avoided if at all possible.

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Yes, if the secondary insurance plan covers it In the pharmacy (drugs) world of primary and secondary coverage, this is true.

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In most cases a secondary insurance would compensate coverage were the primary insurance does not. Exceptions apply to the prescription drug type and coverage limitations.

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With spiraling medical costs, the employees without health insurance coverage will be in total jeopardy. As a result, they will absent from their duties frequently and their working strength will gradually reduce to a low ebb. Considering the above scenario, the employers deems it essential to purchase insurance plans for their employees' health coverage.

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"Star Health Insurance offers coverage in outpatient care, emergency room assistance, hospitalization, pharmaceutical care, and coverage with your primary care provider."

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pertaining to medical insurance; primary secondary TERTIARY IS THE ANSWER

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If you sign up for insurance with your company, You have to indicate who is primary subscriber between yourself and wife. If both a wife and a husband sign up with the same company and both have stated they are primary, Your wasting your money. In the insurance world, secondary insurance was purchased because you want coverage for medical cost and pharmacy cost your primary insurance does not cover. Birthdays having nothing to do with who is first. Indicating on the insurance form as subscriber does.

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If you mean are your medical bills covered -- and assuming your state requires medical coverage on auto insurance policies -- then, no, you wouldn't be covered by any policy of the driver's since, of course, no policy exists. However, if you have your own auto policy, that policy would then become primary. After that, your health insurance would be primary. Unfortunately for the uninsured driver, if you do have to go through your own health insurance, there's a big possibility that they will go after the driver for any payments they make, particularly if a driver is legally required to carry auto insurance in your state (again, insurance that included medical coverage).

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Your personal auto coverage will not cover their vehicles. What they are probably asking for is to make sure you have coverage in case you drive your vehicle on errands or such for the company. If you go to the post office to get the company mail your personal auto insurance will be the primary insurance and then if they have an endorsement to their insurance called "hired and non-owned auto" it will provide secondary coverage over and above your coverage to protect them in case of an accident. Their coverage insists that you as the employee have primary insurance on your vehicle. Also note that the company insurance will not pay for damage to your vehicle.

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Your state may have varying laws about dual coverage, but generally speaking, if you have a primary insurance, they will pay first. Any co-pay or deductible that your primary coverage does not pay will be covered by government insurance.

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Yes, some of your own automobile insurance can cover you while driving your friends car. The coverage that your friend has on the car will be the primary coverage and then if that coverage is insufficient for the damage caused then you can go to your own policy for additional coverage.

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Probably not. Supplemental health insurance is designed to fill holes not covered by major medical insurance plans: deductibles, co-pays, co-insurance, policy limitations, income replacement, and non medical expenses such extra travel, lodging expenses, etc. Major medical insurance is designed to cover your primary need - catastrophic losses associated with a sickness or injury. Supplemental insurance should not be viewed as a replacement to major medical coverage.

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The policy with the broadest scope of coverage is primary. The other policy with less coverage would be considered secondary and does not invoke until or unless the coverage from the primary policy is exhausted.


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