Medical Insurance

When will secondary health insurance not pay?


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2012-06-11 08:49:49
2012-06-11 08:49:49

if primary paid more than allowed amount or if patient has primary insurance

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No. You will have to use your health insurance first.

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.

Here's a basic example of how secondary health insurance works. You go to the doctor, he charges you $100 for the visit. Your primary insurance pays him $50 and disallows $10. The remainder of the bill, $40, then either comes to you to pay or to a secondary insurance. In most cases the secondary will pay most, if not all of the $40.

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

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

They pay premiums for their health insurance, as do other Federal Employees.

No - a employer does not have to pay health insurance.

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 to their maximum -- in addition to what the primary pays, which would result in a higher payment against a claim.

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.

The secondary insurance cover both pays and co-pays of the primary insurance depending with the insurance company.

The true benefit of employee health insurance is that you usually do not have to pay for the insurance. But, if you do have to pay, it is only a small percentage.

Yes the employer can pay the health insurance but is not required to by law. He is encouraged to for bettering the employees benefits.

People pay health insurance to fight against skyrocketting medical expenses and medicine cost.

Health insurance will not pay for this type of procedure. The procedure is elective and therefore it will not be covered by health insurance. I know some people who have had it and they always had to pay for it themselves.

Cosmetic procedures which are not medically necessary are not covered by health insurance.

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.

yes they do have to pay health insurances

Yes, you can get individual health insurance but you may have to pay more for it.

Why not? You just have to pay for it.

No. You auto insurance has to pay first before the health insurance will begin to pay. Usually they want a letter from your auto insurance carrier to prove that all medical payments coverage on your auto insurance has been exhausted.

Different states and policies can have different benefits and coverages. Health insurance will cover medical costs related to an auto accident but in most states they are secondary to automobile insurance. This means that the auto insurance will be responsible for payment first and health insurance will pay after that. If the health insurance company goes ahead and pays the claim or at least the first few bills then you receive payment of file for payments on the auto insurance you will be responsible for reimbursement to the health insurer.

Yes. All people will be forced to pay for health insurance.

If the provider is out of network or not contracted with the secondary insurance, they do no have to bill the secondary and the patient is responsible for the balance (if any) owing

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