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.
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.
It depends. If there are just the two of you, you are 'primary' on your own policy, and your spouse is primary on his/her own policy. By default you would be 'secondary' on your spouse's policy. If the two of you have kids, you can elect either of the parents' insurance carriers to be primary, but you must do this officially, by filing the proper records with the carrier who you want to be primary. Typically, you need to decide which policy will be primary for the kids each year, as you will need to add the kids to one of your policies. You make this choice by reviewing both policies' coverages, copays and costs. The other policy, by default, then becomes secondary. If you just had a child, you should call your human resources department and/or health insurance company to work out the details and get the child properly insured.
Supplemental Medical Insurance is in addition to your primary insurance. It is used to help cover the cost of copays, deductibles, and co-insurance. The most common time of SMI is Medicare Supplement Plan. It helps to cover what the medicare plan doesn't. If a person were to have Medicare Part A & B and also and AARP Supplement plan, it covers their copays for benefits and helps with covering costs of prescriptions.
In health insurance a copay (copayment) is a fixed amount you pay for covered services, typically when you get the service. e.g So if your policy says, 10% Copay and your claim amount is Rs.1,000/- you will have to pay Rs. 100 and the balance Rs. 900 will be paid by the Insurance Company. Generally, The co pay clause is found in health insurance plan. Each plan treats copays differently, so it's important to understand if your plan offers copays, what services they offer them for, and how many of one service you can get at that copay per policy period.
No you do not have to cancel either insurance.. You are what we call in the industry "dually covered". That means that your secondary(husbands) insurance will pay all or most of your copays ( for prescriptions and office visits) and most of your deductible ( if you have one)... Therefore, make sure that all your providers accept both insurances and you are all set to go!!!! If you are wondering if you can cancel your insurance with your job, you will have to call your group administrator to find out because there are special times during the year that you have to make any changes to the policy.. such as cancelling coverage, adding a new baby or removing an ex spouse.
It depends, but the terms are NOT interchangeable. The guarantor is the person or entity financially responsible for the bill. The subscriber is the person who carries the insurance. Example of when they are the same person: An adult carries their own insurance policy (subscriber). They are also financially responsible to pay the charges they incur for the doctor's visit (guarantor). Charges include non-covered services or share of cost such the deductible, copay, or co-insurance. Example of when they are a different person: Adult 1 (father) carries a family insurance policy (subscriber). Adult 2 (son, a college student) is covered under Adult 1's policy. Adult 2 is responsible for their share of cost (such as copays and coinsurance or anything that isn't covered under the insurance policy).
all depends on the blue cross plan you have. A lot I come by through my job as an insurance biller the secondary will pick up any copays that medicare wouldn't cover. But there is some plans that won't pay if medicare doesn't pay. So, really, yea, your secondary should pick up some cost. Unless it is just co-pays, they have the choice to make that your responsibility as a member. Do take the time to figure it out, a lot of times if you don't fight your own claims, you pay much more than you need to. Always keep and look at your explanation of benefits that you should receive from the insurances after each visit explaining what they paid and what they denied and what you owe. Anything that is not listed in the "Allowable Amount" column, you are not responsible for. Especially if the place you attended is participating with that insurance. A lot of companies try to collect for money that was denied by the insurance, but they(the insurance) states you are not responsible for.
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, but 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.
You insurance will have set copays. If you do not have insurance, there is most likely a local clinic you can visit. Or, call the pediatrician's office, and ask for the cost of a visit if you have to pay yourself. They may give you the insurance company's discount off of the full rate, but it will still be more than a copay. Expect to pay for the visit at the time of service.
To best decide which insurance company offers the cheapest rate it would be best to go to an insurance comparison site like essurance.com. You put in your information and insurance prefences, like deductibles and copays, then they will give you multiple insurance quotes from different companies to choose from. This would allow you to choose the cheapest insurance premiums and shop around without having to enter your information multiple times. They represent well known companies and some that aren't as well known to give you a greater variety of quotes.
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