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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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∙ 12y ago
Yes
Wiki User
∙ 12y ago
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If you have a copay with your primary insurance but also have secondary insurance do you have to pay the copay before treatment?
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.
Will secondary insurance pay the co-insurance amount of primary insurance if you have met the deductible in secondary insurance?
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
What happens when one is covered by two insurance plans?
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.
When will secondary health insurance not pay?
if primary paid more than allowed amount or if patient has primary insurance
If the secondary insurance has a higher allowed amount than the primary insurance is the secondary required to pay the higher amount?
I need more details in order to answer this question.
How are primary and secondary insurance determined?
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.
What is the difference between copay and coinsurance when you have primary and secondary insurance?
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
What is a deductible in auto insurance?
A deductible in any kind of insurance is, basically, the minimum amount before the insurance "kicks in." On any repairs covered by your insurance, you will have to pay the deductible amount before the insurance will pay anything.
If you have the same insurance for your primary and secondary can you still end up with a balance you owe?
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).
How do you figure out the write-off with primary and secondary dental insurance?
first you should obtain the explanantion of benefits from your primary. it should indicate what the write off amount is. if you're not sure, call the insurance company and ask them. then do the same with your secondary. the secondary insurance will consider the amount allowed by the primary and will usually base their benefits on that. if you are lucky, between the two, you should have little out of pocket expenses.
What are my options for Low Deductible Insurance?
A low deductible insurance policy simply means that, a low deductible, possibly $200 as compared to $2,000 which would be a high deductible. Often you are also given the option of choosing 80, 90 or 100% co-insurance. Co-insurance is the amount that the insurance company pays (after deductible) up to whatever is the maximum out of pocket amount.
Are health care providers obligated to accept payment from a secondary insurance with whom they participate when the provider does not participate with the patient's primary insurance?
Yes they will have to accept payment from the secondary insurance, however they will have to bill the primary provider first. What ever the primary insurance does not cover should be covered by the secondary insurance. However, it will depend on the service being provided and the contracted amount that each insurance has agreed to pay. If the primary pays more than the secondary would have paid -there may be a refund due. However, there may be co-pays and deductibles to be met with both insurance policies. There could also be write downs--- you should only pay the lesser amount the provider may have to take a loss if one insurance has a lower contracted amount
