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You have Medicare as primary insurance and BCBS as secondary insurance Do you pay the copay on the secondary insurance?


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2013-08-20 04:02:34
2013-08-20 04:02:34

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.

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I have insurance paid for by my employer (primary) and through my husband's employer (secondary). In my experience, I have never had to pay the copay required by my primary because it is covered by my secondary. When I first got married, 2 years ago, I still paid the copay, but the doctor's office would always send me a check for the copay a month later because the secondary paid it.

AnswerIt depends on the allowed amounts. Even if it does pay something it will never pay the entire copay.

I don't quite understand your question. Check this link for links to explanations of dual coverage. Have you read the applicable provisions in your policies?

Depends on the doctors office billing procedures. For more details visit 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.

Yes, most people on Medicare will need to pay a copay in order to go to physical therapy appointments. This is considered to be a specialist. If you have other health insurance outside of Medicare, this may cover the copay amount.

This does not sound like an auto policy, is this medical? If so, you are responsible for the copay. I would contact your benefits administrator.

Medicaid will pay the copay only if the amount of the copay added to whatever the primary insurance paid is less than or equal to what Medicaid would allow for that charge to begin with. Like charge of $50 for a visit, and the copay is $10 and the primary insurance paid $3 and Medicaid allows $15 for that particular code. Then Medicaid would pay $12.00 of it. This is highly unlikely, though.

Your secondary insurance may not cover a pharmacy copay because it is not viewed as necessary or has not been approved. This is usually associated with premium medications or those which have a preferred drug over the prescribed medication.

$141.50 is the copay for Medicare nursing home stays (day 21-100)

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

Yes. That's why one should have Medicaid (if eligible) or supplemental insurance.

Yes, but unlike other procedures that are 80%/20% copay, knee & hips are 70%/30% which means that either secondary insurance pays the thousands of dollars in copayments or the patient pays.

The most popular Medicare HMO is Secure Horizons. It offers a primary care physician that provides referrals to specialists and the insured is only responsible for a copay.

Medicare has various deductibles and co-insurance depending on what service is provided. In general Medicare is known as the 80/20 plan since apart from deductibles payable by the beneficiary, Medicare generally pays 80% of the Medicare allowable amount and the beneficiary pays 20% of the Medicare allowable amount.

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).

Why will family Dr charge me copay and visit to cardiologist does not?

no, there is a deductable and after day 60 there is a per day copay

The copay amount is the different between what the cost of the medical procedure is and what the insurance will cover. Some HMO's have standard copay fees for doctors office visits, other do not. Prescription insurance plans will also have a copay amount, again to cover the cost difference between what the insurance company will pay versus the price of the medication.

Yes. Thanks to health reform, Medicare beneficiaries now get a one-time "Welcome to Medicare" physical exam during the first year after they enrolled in Medicare Part B, and then, after a year enrolled in Medicare Part B, they get a yearly wellness exam. Beneficiaries also receive a decent list of free tests with NO copay and more tests WITH a copay. The details are in the Medicare Resource Center link below.

The co-pay is typically owed to the provider of the service(s).

That will depend on your health insurance coverage.

The Medicare Part B deductible for 2009 is $135.00. After you meet the $135.00 deductible, you will pay 20% of the bill unless you have a Medicare Supplement that pays the 20% for you. Some Medicare Supplements pay the $135.00 for you. If you have a Medicare Advantage Plan (Part C) your "copay" will vary between the type of plan, the company that offers it, and whether or not the doctor is a family doctor or a specialist. If you have one of these plans, usually a PPO or HMO, you don't pay the Medicare Part B deductible of $135.00

This is depending on your company on what your dental insurance plan copay would be. The range for copays for dental ranges from 0-30 dollars.

Office Visits - $20 copay Whenever you go to see your regular doctor you are required to pay a $20 copay.

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