Does secondary insurance cover or pay copays of primary insurance?
The secondary insurance cover both pays and co-pays of the primary insurance depending with the insurance company.
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With Primary and Secondary Insurance your primary denied your claim because it was over a year is your secondary obligated to pay?
Answer . Yes, subject to the limits in their policy.. Answer . No. With most insurance policies, there is what is called a timely filing limitation. For my company; contracted providers have 6 months, and non-contracted providers have 12 months to submit the claim. If your primary insurance r…eceived the claim within timely filing, you may have the option of submitting the claim to your secondary with proof that it was filed in a timely manner. If that doesn't work you can always appeal the decision with the secondary or for that matter the primary insurance company.\n. \n. \nPolicy holders are not responsible for claims that deny for timely filing. ( Full Answer )
Will secondary insurance pay the co-insurance amount of primary insurance if you have met the deductible in secondary insurance?
Answer . You're going to have to look at your policy or brochure to see what the provisions are.\n. \nFor more details see www.steveshorr.com/supplemental.htm.
If you have a copay with your primary insurance but also have secondary insurance do you have to pay the copay before treatment?
%DETAILS% 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. ( Full Answer )
Answer . \nAs long as it is a covered expense by your secondary insurance and a claim has been filed with the primarty insurance then the answer is yes. The secondary insurance will only cover the expense according to your plan.
Answer . \nYes, if the secondary insurance plan covers it In the pharmacy (drugs) world of primary and secondary coverage, this is true.
If the primary charges a 200 copay the secondary pays nothing do you owe the 200 copay on the primary if secondary states 0 owed by patient Where can you find this info?
Answer . This does not sound like an auto policy, is this medical? If so, you are responsible for the copay. I would contact your benefits administrator.
You need information on how copays effect primary and secondary insurance If you pay your copay on primary does that off set your copay on secondary and would secondary pay remaining portion of bill?
Answer . I don't quite understand your question. Check this link http://www.steveshorr.com/technical_questions.htm#Primary for links to explanations of dual coverage. Have you read the applicable provisions in your policies?
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.
If you are on two medical insurance plans and the primary will not pay for a prescription can the secondary be used to cover it?
Answer . Depends what the 2nd policy pays for. Doesn't hurt to send in the claim forms. Try reading the policy or brochure.
Medical Insurance Answer . What does the brochure or policy Evidence of Coverage for the secondary policy say?
Answer . \nFirst check your policy. Then check http://www.steveshorr.com/technical_questions.htm#Primary for the rules on who pays first.\n. \nBasically a 2nd policy will pay what the primary didn't, but not more than 100% of your bills.\n. \nIf the bills are not relevant, then it's a supplem…ental policy. ( Full Answer )
You have two primary health insurances and want to know if they both have to pay as primaries not as a secondary and what happens if a bill gets overpaid when they both pay?
Answer Eventually the insurances will figure out that one is overpaying and they'll get refunds from the doctors. Note that some policies do not coordinate and then they both might pay as prime correctly.
Secondary medical insurance is a second level of insurance coverage. Under most circumstances, the two policies are independent of each other. One policy may pay for a service while the other may not. The primary policy must pay first, then the secondary. The choice of which policy is primary or sec…ondary is established by a shared rule between insurance companies. It is not the policy holder's choice. Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy. ( Full Answer )
Will a secondary insurance pay a portion or all of a prescription that a primary insurance will only pay part of because they will only pay for a lower dosage?
In most cases a secondary insurance would compensate coverage werethe primary insurance does not. Exceptions apply to theprescription drug type and coverage limitations.
Answer . A co-pay is a flat payment that is the responsibility of the patient that is assessed to an event; such as a doctor visit or a prescription purchase. Similare to a copay...co-insurance is typically a calendar year responsibility of the patient; such as 20% or 30% that is paid by the pa…tient after meeting a deductible (if applicable). There is usually a maximum out-of-pocket limit, such as $1,000, $2,000 or higher that is the most a member can pay prior to the plan paying 100% during a calendar or benefit year. Copays do not always count toward the out-of-pocket limit.. Example of how a co-pay event might work..... Patient visits doctor for cold. Patient pays $20 co-pay at time of visit. Doctor bills insurance $100 for "sticker price" of the visit and $20 for labwork. Because the doctor is a contracted "in-network" provider, the insurance carrier only allows $65 to be charged for the office visit. Since $20 has already been paid by the patient, they send a payment to the doctor of $45. The insurance carrier determines that the $30 is subject to coinsurance and pays 80% and determines that the patient is responsible for the other 20% - or $4. The patient would ultimately receive a bill from the doctor for $4. ( Full Answer )
The subscriber whose birthday comes first in the year is primary. The year is not considered. So a subscriber with a January 1 birthday is primary over the subscriber with a January 2 birthday. Hope this helps.
Not necessarily; a secondary insurance policy or plan might only provide additional benefits up to the maximum that it will pay for a specified service. If both plans have rates that are similar, this might result in a small additional payment. Some secondary insurance or health plans might pay up t…o their maximum -- in addition to what the primary pays, which would result in a higher payment against a claim. ( Full Answer )
You have Medicare as primary insurance and BCBS as secondary insurance Do you pay the copay on the secondary insurance?
The answer to this question depends on what kind of secondaryinsurance you have - is it a group health plan? Is it asupplement? . If Medicare is primary, there are still deductibles, copays,coinsurance that would need to be satisfied by your secondaryinsurance. . Based on your question, I'm assumi…ng that you have a group healthplan with a copayment as your secondary insurance. If so, then yes,you would pay your copayment but it would not exceed the part Bdeductible. ( Full Answer )
A Copay is a flat dollar amount that needs to be paid to a health care provider for services rendered. There may or may not be "coinsurance" applied after this flat dollar fee is paid. A Copay varies by the health plan benefits. Typical physician office copays are $20, $30 or $35 per visit.
You could have two insurance companies pay the same medical bill or claim for a date of service through a process of subrogation where the first insurance company determined by the effective date of coverage will pay their portion of the bill and the second insurance company will pay the balance. Th…is process is called coordination of benefits. Secondary medical insurance is a second level of insurance coverage. Under most circumstances, the two policies are independent of each other. One policy may pay for a service while the other may not. The primary policy must pay first, then the secondary. The choice of which policy is primary or secondary is established by a shared rule between insurance companies. It is not the policy holder's choice. Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy. Secondary insurance should not be confused with supplemental insurance. Supplemental policies usually abide by the primary insurance guidelines. If the primary allows the charge, the supplemental will allow the charge. Most supplemental policies cover the charges you would normally pay out of pocket. For example: A Medicare supplemental policy would cover the 20% coinsurance left over after Medicare pays 80% of the allowed amount. ( Full Answer )
Can you change your secondary insurance to primary insurance if your coverage is better with the secondary insurance?
In most cases no. You can not chage due to better coverage. 90% of insurance companies, if not more, have what is called a birthday rule. Meaning if you have dependant children on the policy the guardian who was born first (or who is older) is the primary carrier for the dependant children and the y…ounger of the two guardians is the secondary carrier. If you were to have coverage through yourself and a spouse you would be your own primary, as would your spouse be their own primary. If you are the carrier for both insurances then it would all depend on your plan provisions and restrictions, in which case you would have to question each insurance company as to how they would handle determining what insurance is primary and what insurance is secondary. ( Full Answer )
Secondary: a policy that pays the provider's leftover medical bills. Some might still exclude the payment toward bills assigned to meet the primary policy's deductibles or copayments so you have to ask. This happens for instance if a husband or wife covers their spouse on their insurance but he/she …also participates in their employer's plan. The spouse's coverage would pay the bills after their own medical plan paid. ( Full Answer )
If your insurance company pays for a hospital stay and you are left with a copay you can't afford what can you do?
contact their accounts receivable department and make plans for a payment plan.\nthey will not go away if you ignore them and they will hound you relentlessly for\ntheir payment. start with small payments - $20 a month - try to get it paid down\nas quick as possible and don't miss any agreed on pay…ments. medical will ruin your\ncredit report if you let it get out of control. ( Full Answer )
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 h…ave 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 ( Full Answer )
When you have a primary and secondary insurance will the co-pay from your primary insurance be paid by the secondary insurance?
I have insurance paid for by my employer (primary) and through my husband's employer (secondary). In my experience, I have never had to pay the copay required by my primary because it is covered by my secondary. When I first got married, 2 years ago, I still paid the copay, but the doctor's office w…ould always send me a check for the copay a month later because the secondary paid it. ( Full Answer )
If both policies are with the same company, and if you or your employer pays the premiums on them, then yes, they both pay. That is actually common; quite often the husband's insurance through his employer is through the same insurance company the wife's job has.
If a husband and wife both have dental insurance through their employers, the employee's insurance is primary when the employee is the patient, and it must pay it's benefits. The spouse's insurance is secondary, and will only pay once the primary insurance has paid. Depending on how the policy is wr…itten, sometimes the secondary insurance will pay any residual fees up to the annual maximum. Sometimes the secondary insurance only pays if their fee schedule allows higher fees than the primary insurance. This assumes that each spouse is named as a dependent on each other's policy. Ask the insurance coordinator at your dental office to what benefits are available between the two policies. ( Full Answer )
When a primary insurance payer pays 0 on a 1000 bill and a secondary pays 700 with a 700 contracted amount do you have to pay the difference 300?
With out a doubt...yes. Unless your dentist is a contracted provider through your insurance company, in that case they might have to adjust your account to what the contracted (allowed) fee is per the insurance company. If they are not a contracted provider they don't have to adjust one dime!
Primary insurance coverage is what is first used when a medicalservice is being rendered. This is what will be billed first.Secondary insurance is supposed to cover what the primary insurancedoes not.
If the primary insurance allows more than the secondary insurance what would the secondary insurance pay?
Secondary insurance will not pay the claim but the remaining charges should not be billed to the member/patient. Provider of service should write off the patient responsibility that primary insurance applied.
As a provider i file primary insurance. do I have to also file secondary insurance after primary pays?
You should or you customer WILL be PISSED for having to do the leg work of getting the information of what the primary paid and getting it to their secondary.
yes, they will treat it as if the primary was a different company. You pay two premiums. If they do not, contact the DOI.
If Medicare is your secondary insurance and your primary insurance is paying only a part of the bill can the hospital sue you for anything?
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. ( Full Answer )
Put simply, yes, you can buy travel insurance or travel health insurance without primary insurance. That's just as well, as your primary insurance may not cover you (or cover you completely) when you travel overseas.
When a DPPO is primary coverage, the charges paid by the patient are based on the agreed DPPO discounted fees--not the DHMO schedule of charges. The dentist would bill the DPPO for the procedures performed. If the dentist is in the DHMO network, he or she would also get his or her regular capitation… payment for that patient. ( Full Answer )
The answer to that question depends on a few things. 1. Group insurance policies are always primary over personal or self bought policies...ie You work for ABC company. You have insurance thru them (group policy) and you also pay for an individual or personal policy. Your policy thru ABC would be pr…imary 2. Government insurance (except for medicare) is always 2nd...ie Tricare, medicaid, and etc. 3. An active policy is always primary over a retiree policy. For example John retired from ABC company and has insurance thru them. He currently works for DCE company and has a policy thru them. The DCE policy would be primary and the ABC policy 2ndary 4. If you are retired and have medicare. Then medicare is primary but if you are actively working your group insurance would be primary. 5. When it comes to children the order is 1. Parent who's birth month comes 1st if both parents are born in the same month it goes by the day (the year doesn't play a role in this) 2. If parents are divorce it goes by 1. court order if not applicable goes by who has custody is primary this includes step parents. The step parent who has custody of a child, their insurance is primary. There are a few other rules when it comes to who is primary...when in doubt contact your insurance company ( Full Answer )
If a person has two Medical insurances and the primary denies due to preexisting will the secondary pay?
It depends on a few things. If your primary insurance is say less than 2 years old, they can deny claims to determine whether the condition is pre-existing. If you have had the secondary policy longer/ or the pre-x period has already been satisfied, then they may pay the claim as secondary. As long …as the treatment is indicated as covered benefits in the policy. These cases are common when both spouses have covered each other on their jobs. And/or when a child is covered under both parents policies. There could be a coordination of coverage issue with the latter. ( Full Answer )
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).
There are some supplemental insurances that will cover incidents that come up. You use the money as you see fit. Usually though, you are really saving money by taking an insurance that has a higher deductible/copay since the premiums are lower. We are so used to an all-encompassing insurance plan, b…ut those are going by the wayside in the current (2010) market. Also, if you contribute to a health savings plan, that money is pre-tax and is cheaper to use for copays. ( Full Answer )
Usually with vision and/or eye insurance, there is a co-pay. But there are some cases in which there is none. It all depends on what type of insurance you have.
A supplemental or an indemnity policy will work in conjunction with your Major Medical policy, you may have to file the claims yourself though. The best place to look for an indemnity for good overall coverage is Homeland Healthcare.
Do you have to pay the medicare deductible if they are paying secondary to a primary insurance carrier?
Every covered life, whether utilizing Medicare as primary or secondary insurance is subject to the same, annual Medicare deductible.
It is usually written in an insurance policy if the policy is primary or secondary. If both policies have language that makes them secondary if other insurance is present then they may split the amount owed. State laws may change this.
We have Medicare and added on Anthem. Does that mean Medicare is primary (Paying 80 percent) , and Anthem is secondary?
No. If you have a deductible with your primary carrier, you will have to pay the deductible first before Medicare will pay anything.
Absolutely. I'm not sure what type of insurance you are talking about in particular but you are always required to tell insurance companies of other carriers that may have some liability in a claim. It is illegal to make money from a claim in this manner. Be very careful about items like this that c…an get you into a great deal of trouble with a felony charge of insurance fraud. ( Full Answer )
Medicaid will pay the copay only if the amount of the copay added to whatever the primary insurance paid is less than or equal to what Medicaid would allow for that charge to begin with. Like charge of $50 for a visit, and the copay is $10 and the primary insurance paid $3 and Medicaid allows $15 fo…r that particular code. Then Medicaid would pay $12.00 of it. This is highly unlikely, though. ( Full Answer )
Your secondary insurance may not cover a pharmacy copay because it is not viewed as necessary or has not been approved. This is usually associated with premium medications or those which have a preferred drug over the prescribed medication.
Within each policy there is a clause called the coinsurance clause which will spell out which policy will be primary and which is secondary. I assume that you are referring to health insurance and not any other type of insurance as this occurs mostly in health insurance cases. There are different me…thods of determining this so that is why I have to refer you to your specific policy. Some of the method can be: which policy started first, which policy owner has the earliest birthday during the year, and there are a few more methods. In any case the insurance carriers will determine which is primary. This will result in which policy pays first and which policy pays the remainder. The total paid by both companies can never exceed the amount of the bills so you cannot benefit no matter how many policies you have. It is illegal to profit from insurance payouts like this. ( Full Answer )
What happens when your primary insurance does not have a hospital in network but your secondary insurance does?
File a claim with both companies. The companies will pat what they are supposed to pay.