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Will secondary insurance pay the co-insurance amount of primary insurance if you have met the deductible in secondary insurance?

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2004-12-02 08:38:36
2004-12-02 08:38:36

You're going to have to look at your policy or brochure to see what the provisions are. For more details see www.steveshorr.com/supplemental.htm

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Related Questions


Is the patient responsible for deductible and coinsurance if primary insurance paid more than secondary would have allowed.

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.

Every covered life, whether utilizing Medicare as primary or secondary insurance is subject to the same, annual Medicare deductible.

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.

It's secondary or tertiary insurance that is held to cover any medical expenses the primary insurance policy does not cover or does not cover completely.

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.

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 have 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

Primary has to process and pay claims first then secondary will process and pay leftover expenses according to their policy provisions. The secondary sometimes excludes payment towards a primary policy deductible.

No. If you have a deductible with your primary carrier, you will have to pay the deductible first before Medicare will pay anything.

Often, a person will have "primary" insurance and "secondary" insurance. For example, if you have insurance through your job, and your husband has insurance through his job, then your primary insurance will be the one through your job, and your secondary insurance will be the one through your husband's job. Also, your husband's insurance through his job will be his primary, and yours through your job will be his secondary. There can be some exceptions to this though. For example, if you were married, had a child, then divorced and remarried (retaining custody of the child), and both your ex and current husbands have insurance through work, then the one who's birthday is first is considered the "primary" insurance, and the other is the "secondary" insurance. But there will still be a deductible with each one that has to be met before either one will pay.

That is if the secondary does not have a clause in it that "they will not duplicate benefits" If so they will not always pay the difference. They will figure out the amount they would normally pay, subtract what the primary pays from that amount and pay the difference (which with mine is little to nothing and I end up paying the balance of the bill) Nothing really happens, one is the primary and the other is the secondary insurance for the patient. Primary insurance will pay up to 80% of allowed charges if the deductible is met, and the secondary insurance will pay the remaining 20% of the claim, again, if the deductible for the year has been met.

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

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

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.

Yes, you can. The other insurance would be primary though and the Medicaid secondary.

You cannot decide which insurance is primary and which is secondary. Their is nothing you can do to determine this. Within each policy it specifies when each policy is primary or secondary. With Medicare, it is always going to be secondary to insurance provided by an employer or retirement plan.

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.

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.

If you have insurance through your employer, and you are the policy holder,(the insurance is in your name) this insurance will be primary for you, and your spouses insurance policy will be secondary. The insurance policy thru your spouse's employer, (your spouse is the policy holder, or the insurance is in their name), this would be primary for your spouse, and your policy would be their secondary. Here's the phamplet from Medicare http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf

Having the same insurance company twice, as a primary and secondary, means you are paying twice for the same insurance policy. They probably will not cover the same thing twice, or they may treat it as two different policies and may treat it that way. If they were two different policies, The primary would deal with any deductible and copay before fulfilling its contractual obligation and so would the secondary policy depending on the wording of the contract. Unless there is no deductible and copay, or if one policy covers the deductible/copy of the other, there will still be a balance you owe. There is also the situation where your medical provider will not accept or fully participate in your insurance policy, in which case you may owe the difference between the doctors bling amount and what was paid by the insurance(s).

No, it's fraudulant. It's not practical, the secondary insurance should pay the remainder of the cost the primary insurance doesn't cover.

pertaining to medical insurance; primary secondary TERTIARY IS THE ANSWER

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


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