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Medical Insurance
Retirement Planning
Medicare and Medicaid

How do dual participation or primary and secondary insurer rules apply when one of the insurers is an HMO?


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Wiki User
2015-07-15 18:31:34
2015-07-15 18:31:34

Check this page http://www.steveshorr.com/law_relating_to_insurance.htm for links to various insurer's sites on this subject

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Normally, the health care provider will collect primary and secondary insurance information from the patient at the time of treatment. The provider will bill both insurers, and the primary insurer will pay its share. Both insurers are subject to the "prompt pay law" of the State in question, and payment by the respective companies of their shares must be made within that period. Otherwise, there is at least a technical violation of the State's Insurance Code. The "prompt pay law" may provide that the late-paying insurer must pay interest on the late payment.

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No. 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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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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