Do you need to send a claim to your primary insurance company first if they do not cover the treatment but your secondary insurance will?
Do insurance companies cover an accident when it is your fault and you don't get the other drivers information for the claim?
Yes, you would be covered by YOUR insurance company, given you have "Full-Coverage" coverage on your policy. Keep in mind, when filing a claim with your own insurance company, that this claim will follow you on a permanent insurance record for 5 years, possibly more in depending on your state. So be… very wary of claiming an accident that was someone else's fault on your insurance. This may raise your premiums, or make you ineligible for insurance through A rated companies. If you have any more questions, direct them to my email. Sean (MORE)
With Primary and Secondary Insurance your primary denied your claim because it was over a year is your secondary obligated to pay?
Answer . Yes, subject to the limits in their policy.. Answer . No. With most insurance policies, there is what is called a timely filing limitation. For my company; contracted providers have 6 months, and non-contracted providers have 12 months to submit the claim. If your primary insurance r…eceived the claim within timely filing, you may have the option of submitting the claim to your secondary with proof that it was filed in a timely manner. If that doesn't work you can always appeal the decision with the secondary or for that matter the primary insurance company.\n. \n. \nPolicy holders are not responsible for claims that deny for timely filing. (MORE)
If you have a copay with your primary insurance but also have secondary insurance do you have to pay the copay before treatment?
%DETAILS% 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. (MORE)
Can Secondary Insurance not pay anything on claim if Medicare pays more on claim than they would if they were primary?
Yes, If medicare pays more than the secondary insurance allows for a charge, the secondary insurance pays nothing. The balance is written off to a contractual allowance that is agreed upon between the provider of service and the insurance company via contract.
Homeowners policies do not cover damage to motorized vehicles(except lawnmowers, golf carts, off-road vehicles, electricwheelchairs). SOMETIMES there is coverage for boats & theirtrailers when stored in an enclosed building on the premises.
Answer . \nAs long as it is a covered expense by your secondary insurance and a claim has been filed with the primarty insurance then the answer is yes. The secondary insurance will only cover the expense according to your plan.
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 secondary insurance cover both pays and co-pays of the primaryinsurance depending with the insurance company.
If you are on two medical insurance plans and the primary will not pay for a prescription can the secondary be used to cover it?
Answer . Depends what the 2nd policy pays for. Doesn't hurt to send in the claim forms. Try reading the policy or brochure.
Medical Insurance Answer . What does the brochure or policy Evidence of Coverage for the secondary policy say?
Answer . \nFirst check your policy. Then check http://www.steveshorr.com/technical_questions.htm#Primary for the rules on who pays first.\n. \nBasically a 2nd policy will pay what the primary didn't, but not more than 100% of your bills.\n. \nIf the bills are not relevant, then it's a supplem…ental policy. (MORE)
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 sec…ondary 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. (MORE)
Can the secondary insurance provider deny a claim that was not filed with the primary insurance provider first?
\n. \n Answer \n. \nLet me tell you what happend to me. I hope that this helps. I used to be covered by two insurance companies. My primary insurance company was through the company that I worked with. My secondary was with the company that my husband works with. When a claim was filed with… my secondary insurance company they wanted to know how much my primary insurance company paid for and until then they would not pay anything. So I had to submit to my primary insurance company and once they paid some then the secondary would. I hope that this helped:)\n. \n . \n Yes.\n. \nA claim must always be made with the primary insurer first. (MORE)
GAP . No because GAP covers any GAP between what you owe on the car and the cars actual market value if the should your loan balance happen to exceed what your car is actually worth. If you owe $16,000 on a car but you owe 18,000, GAP would kick in and pay the remaining 2,000. You would still e…nd up with zero dollars, but you also don't have to worry about paying off a loan on a car you no longer own. (MORE)
Life insurance claim . Copy of the policy, or at least its policy number; and proof of death.
Will an insurance company pay a claim that occurred during a covered period if you cancel the policy?
Yes, So long as the policy was not already canceled at the time of the loss.
The subscriber whose birthday comes first in the year is primary. The year is not considered. So a subscriber with a January 1 birthday is primary over the subscriber with a January 2 birthday. Hope this helps.
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 t…o their maximum -- in addition to what the primary pays, which would result in a higher payment against a claim. (MORE)
You have Medicare as primary insurance and BCBS as secondary insurance Do you pay the copay on the secondary insurance?
The answer to this question depends on what kind of secondaryinsurance you have - is it a group health plan? Is it asupplement? . If Medicare is primary, there are still deductibles, copays,coinsurance that would need to be satisfied by your secondaryinsurance. . Based on your question, I'm assumi…ng that you have a group healthplan with a copayment as your secondary insurance. If so, then yes,you would pay your copayment but it would not exceed the part Bdeductible. (MORE)
You could have two insurance companies pay the same medical bill or claim for a date of service through a process of subrogation where the first insurance company determined by the effective date of coverage will pay their portion of the bill and the second insurance company will pay the balance. Th…is process is called coordination of benefits. 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. (MORE)
Can you change your secondary insurance to primary insurance if your coverage is better with the secondary insurance?
In most cases no. You can not chage due to better coverage. 90% of insurance companies, if not more, have what is called a birthday rule. Meaning if you have dependant children on the policy the guardian who was born first (or who is older) is the primary carrier for the dependant children and the y…ounger of the two guardians is the secondary carrier. If you were to have coverage through yourself and a spouse you would be your own primary, as would your spouse be their own primary. If you are the carrier for both insurances then it would all depend on your plan provisions and restrictions, in which case you would have to question each insurance company as to how they would handle determining what insurance is primary and what insurance is secondary. (MORE)
You have had payments for claims recouped because the insurance company was secondary the primary insurance company is denying the claims recouped due to timely filing Is there anything you can do?
If your health insurance is thru your employer, have them contact their account rep. These issuse can be magicaly resolved when it is time to renew the company policy, if the rep is informed thast the company will seek another provider should it not be taken care of.
Answer . Absolutely. Health plans only pay for what the policy states. Even if your doctor says something is medically necessary, if the policy does not cover it then they do not pay. The easiest example is drugs. if your plan only pays for generic drugs and your doctor says you must take a non-g…eneric then the insurance will pay zero. (MORE)
When you have a primary and secondary insurance will the co-pay from your primary insurance be paid by the secondary insurance?
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 w…ould always send me a check for the copay a month later because the secondary paid it. (MORE)
Some insurance policies will pay for depression treatments. You need to get your policy out and look through it. If you can't find it, either call your insurance agent or make an appointment to speak to your benefits coordinator. Many policies will pay for a certain amount of psychiatric treatment, …but have a "cut off" point. I personally do not file my group therapy on my insurance for this reason - I save up the money and pay cash, and let my insurance pay for the higher priced psychiatric visits instead. (MORE)
If a husband and wife both have dental insurance through their employers, the employee's insurance is primary when the employee is the patient, and it must pay it's benefits. The spouse's insurance is secondary, and will only pay once the primary insurance has paid. Depending on how the policy is wr…itten, sometimes the secondary insurance will pay any residual fees up to the annual maximum. Sometimes the secondary insurance only pays if their fee schedule allows higher fees than the primary insurance. This assumes that each spouse is named as a dependent on each other's policy. Ask the insurance coordinator at your dental office to what benefits are available between the two policies. (MORE)
If a doctor sends you for a procedure that is not covered by insurance how can you get your insurance company to pay for it?
you can ask your doctor to write a letter of medical neccesity and even ask for an alternate benefit if one is available for the procedure. However, if it is stated in your benefits handbook that it is not a covered expense, you more than likely are wasting your time and the insurance company will n…ot pay. (MORE)
Primary insurance coverage is what is first used when a medicalservice is being rendered. This is what will be billed first.Secondary insurance is supposed to cover what the primary insurancedoes not.
Standard health insurance typically does not cover fertility treatments. 17 states mandate coverage, for companies employing more than 50 employees. If you work for one of these companies, you will have coverage. If not, you have to be creative.. Here are some options -. Rebate programs will retur…n a portion of your fertility costs if the procedure does not work. . Fertility financing allows you to borrow money to pay for the procedures over time, with interest . The IRS will subsidize a portion of the cost through tax savings. These expenses are deductible. You will get the biggest tax break by using your flexible spending account at work. . Supplemental insurance covers normal labor and delivery provided you enroll preconception. Your benefit may greatly exceed your premium helping to offset the fertility cost and mom's lost income. (MORE)
The policy with the more comprehensive coverage would pay first or the companies will negotiate with each other.
yes, they will treat it as if the primary was a different company. You pay two premiums. If they do not, contact the DOI.
Most often not. Some state mandate some level of coverage for companies with more than 50 employees. If you work for a large employer in headquartered in one of these states, that your treatments may be covered. Supplemental health insurance is available to couples in all 50 states, and all emplo…yers with 3 or more employees. You can create maternity leave income, and gain protection for complications, premature birth, accidents and illnesses. You can pay for your fertility treatments using an FSA, and cut your costs by 1/3. (MORE)
Is it required to make a primary dental insurance adjustment if the dentist is a preferred provider before submitting a claim to secondary insurance?
You wait until both claims are received then write off the lesser of the two amounts
A claim is a liability on part of the insurance company. If a customer makes a claim it means that the insurance company has to pay the customer for the amount is eligible to claim and hence it is a expenditure on the balance sheets of the insurance company.
Put simply, yes, you can buy travel insurance or travel health insurance without primary insurance. That's just as well, as your primary insurance may not cover you (or cover you completely) when you travel overseas.
What insurance companies will give cover for will depend on many factors. The nature of an illness and the job someone has and the environment they are working on would be very important factors. Different countries would have different laws on what companies can do, and different companies would …have different guidelines for their policies. So it is not possible to give a direct answer to your question as there are so many factors to consider. (MORE)
When a DPPO is primary coverage, the charges paid by the patient are based on the agreed DPPO discounted fees--not the DHMO schedule of charges. The dentist would bill the DPPO for the procedures performed. If the dentist is in the DHMO network, he or she would also get his or her regular capitation… payment for that patient. (MORE)
The answer to that question depends on a few things. 1. Group insurance policies are always primary over personal or self bought policies...ie You work for ABC company. You have insurance thru them (group policy) and you also pay for an individual or personal policy. Your policy thru ABC would be pr…imary 2. Government insurance (except for medicare) is always 2nd...ie Tricare, medicaid, and etc. 3. An active policy is always primary over a retiree policy. For example John retired from ABC company and has insurance thru them. He currently works for DCE company and has a policy thru them. The DCE policy would be primary and the ABC policy 2ndary 4. If you are retired and have medicare. Then medicare is primary but if you are actively working your group insurance would be primary. 5. When it comes to children the order is 1. Parent who's birth month comes 1st if both parents are born in the same month it goes by the day (the year doesn't play a role in this) 2. If parents are divorce it goes by 1. court order if not applicable goes by who has custody is primary this includes step parents. The step parent who has custody of a child, their insurance is primary. There are a few other rules when it comes to who is primary...when in doubt contact your insurance company (MORE)
Medicaid is always the payor of last resort. Before a Medicaid agency pays a bill for a Medicare beneficiary, they require documentation that Medicare has "adjudicated" the bill (i.e., decided whether to make payment and, if so, how much).
if it goes under payment account audit they will find out eventually and try to recoup whatever the overpayment was for that claim.
After you have received the Explanation Of Benefits (EOB) from your primary carrier if there is coordination of benefits. If the secondary insurance is an indemnity you do not need to wait.
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.
We have Medicare and added on Anthem. Does that mean Medicare is primary (Paying 80 percent) , and Anthem is secondary?
An insurance contract is an agreement between the insurer and the insured. By its terms, in return for the payment of a premium by the insured, the insurer agrees to pay on behalf of the insured, certain damages for which the injured may be legally liable. The insurer may have other obligations, too…, such as to provide a defense (hire a lawyer and pay related expenses) on behalf of the insured. It is important to understand that both the insurer's and the insured's obligations are specified in the policy. Therefore, if there is an occurrence that falls outside of the undertakings of the contract, the policy will not provide coverage. An example of this is that an auto insurance policy does not provide coverage for damage to furniture caused by a house fire. Likewise, if the insured has not paid premiums as agreed and the policy lapsed before a covered occurrence happened, the insurer may properly deny coverage because the policy was not in force at the time of the occurrence. There are other circumstances under which an insurer may be within its rights not to pay. Just what those circumstances are depend upon the kind of insurance involved and the facts of the dispute. (MORE)
Absolutely. I'm not sure what type of insurance you are talking about in particular but you are always required to tell insurance companies of other carriers that may have some liability in a claim. It is illegal to make money from a claim in this manner. Be very careful about items like this that c…an get you into a great deal of trouble with a felony charge of insurance fraud. (MORE)
Do you need to obtain prior authorization from your secondary insurance even if the primary insurance will be billed first?
Your secondary insurance has different PA criteria than your primary insurance. A PA means that your insurer will only cover a service under certain circumstances; company A may cover a service for 3 conditions and company B may only cover the same service for only 2 conditions. Your primary could p…ay and your secondary may not. (MORE)
Chiropractic treatments are covered by insurances, but it takes a little bit of work to get them covered depending on which insurance carrier a person has. HMO's (Healthcare Management Organizations) cover chiropractors on their approved list, and PPO's will cover anyone.
Nothing. In fact, they don't require a copy of the title. I recently got my pink slip and called my insurance and had them take off the loan company. That was it .
Within each policy there is a clause called the coinsurance clause which will spell out which policy will be primary and which is secondary. I assume that you are referring to health insurance and not any other type of insurance as this occurs mostly in health insurance cases. There are different me…thods of determining this so that is why I have to refer you to your specific policy. Some of the method can be: which policy started first, which policy owner has the earliest birthday during the year, and there are a few more methods. In any case the insurance carriers will determine which is primary. This will result in which policy pays first and which policy pays the remainder. The total paid by both companies can never exceed the amount of the bills so you cannot benefit no matter how many policies you have. It is illegal to profit from insurance payouts like this. (MORE)
What happens when your primary insurance does not have a hospital in network but your secondary insurance does?
File a claim with both companies. The companies will pat what they are supposed to pay.