Does secondary Medicaid cover the deductible cost of a primary insurance plan?
Medicaid usually covers your deductible, but will pay ONLY up to the Medicaid allowable for coinsurance costs.Here’s a simple scenario. You have Medicare Primary and go to a doctor appointment. That office bills $100 for the visit and uses a CPT billing code. That code is plugged into the Medicare Fee Table and the Medicare allowable for that visit is $80, so the doctor gets a check for $80. Now there’s $20 coinsurance balance.The office bills Medicaid for this $20, showing Medicaid the EOB statement that they already got $80 from Medicare.Medicaid has an allowable Fee Table as well for each belling code, and if that amount equals what the doctor was already paid (the $80), then there isn’t any additional payment from Medicaid.Hope I haven’t totally confused everyone.
Primary pays a larger percentage than secondary, so secondary refuses to pay balance?
Correct. That's how it works. That's why paying for two different health insurances, probably doesn't make financial sense. What was the GOAL of the secondary insurance? Why did you buy it? When you bought it, did you LOOK at how dual coverage would apply, or did you just guess at how it worked? Here's how it works. The negotiated discount for the PRIMARY insurer applies to the bills. The primary pays, subject to it's copayments, coinsurance, and deductible. The secondary looks at what the primary pays, and if their copay is lower, they pay the difference between their copay and the primary copay. If their deductible is lower, they pay the difference between their deductible and the primary deductible. If their coinsurance is lower, they again pay the difference. If their coinsurance, copay, or deductible, is the same or higher, THEY PAY NOTHING. They didn't benefit from your pocket. They sold you coverage, you knew (allegedly) up front what you were buying. Sounds like you did "do it yourself" insurance. Sounds like you did it to yourself.
How does Medicaid work as a secondary health insurance?
I also have BCBS through my mother, which is listed as the primary insurance at my OB's office. I applied for Medicaid and now have it as my secondary insurance. I simply updated my information with my OB's office once I received the information from Medicaid, and they added it to my file. When I registered at the hospital where I will deliver, I was told to only list Medicaid as the insurance, as it can cause problems when they try to process BCBS, and it gets declined. If you do receive Medicaid, ask the hospital registration staff where you will deliver, if it is best to list only Medicaid. It is a good idea to apply for Medicaid, since your BCBS plan may not cover any prenatal care, my plan does not. Medicaid covers all of it, down to the delivery. If you do apply and receive Medicaid benefits, just make sure to give the information to your OB as soon as you get it, so they can update your records and you can have your expenses covered as soon as possible. Best wishes and take care!
If a person has medicare ins. and connecticare ins, which is the primary ins?
Connecticare is a Medicare Advantage plan. When you have a Medicare Advantage plan Medicare itself does not get billed; they don't even see the billing. The plan itself gets the bill and pays the bill and you are responsible to pay the co-pays. The doctor won't even send a bill to Medicare. If you go to a doctor that is not in network and you have the HMO neither Connecticare nor Medicare will pay the charges even if the doctor does send a bill to Medicare. If you have the HMO/POS you can go outside of the network but there still may be charges that the plan doesn't pay and Medicare won't pay either. If you have a specific question you'll want to ask your agent; they will have or will find the answer.
Do you need Medicare if you have Medicaid?
If you qualify for Medicare you MUST take Medicare. When you qualify for Medicare Medicare becomes primary and Medicaid becomes secondary. Medicaid WILL NOT pay the charges that Medicare will pay, so if you don't have Medicare you are responsible for those charges. For example, if the doctor bill is $100 Medicare pays $80 and Medicaid pays $20. If you don't have Medicare YOU pay $80 and then Medicaid will pay $20. Also, if you qualify for Medicare Medicaid will no longer pay for any prescriptions so you'll have to pay for them. However, if you qualify for Medicaid you'll also qualify for the state to pay your Medicare premiums. You'll probably also qualify for Low Income Subsidy which can pay all or part of your Part D prescription coverage and will lower the cost of your medications. Your insurance agent can explain all of this to you. They can also let you know of additional coverage you can get, such as dental, free of charge if such plans are available in your area.
Medicaid versus COBRA
Only by going through your plan document, provided by your past employer, can you determine whether the coverage is more comprehensive with COBRA vs. Medicaid. COBRA coverage is available for 18 months. The question I would ask you is whether you can afford to make the payments under COBRA. If not, then you would be better off going with Medicaid. One disadvantage of going through Medicaid is that not all doctors are accepting new Medicaid patients. So, if you have a chronic illness and you need immediate care, you might have trouble finding a participating provider. The most important thing is to have continuous health care coverage. That way, you cannot be denied coverage with a new insurer for a pre-existing condition.
How long does it take for medicare and medicaid to approve a power wheelchair?
I have Medicare as a Primary and Medicaid as a secondary insurance I know medicare only pays 80% and my secondary insurance will pay for the other 80% i am suppose to be getting a new motorized wheelchair Medicare already approved their portion now how long will it take for Medicaid to approve theirs I have been stuck in the house for a couple of months due to not being able to get around
I inadvertently used a secondary health insurance card. Should the secondary insurance policy be responsible for the amount that the primary insurance would not pay?
I inadvertently used a secondary health insurance card. Should the secondary insurance policy be responsible for the amount that the primary insurance would not pay?The secondary insurer is responsible for the amount that the primary insurer does not pay, after adjustment for the “approved amount,” less any copay or coinsurance that would be the patient’s responsibility.The secondary insurer should know that it’s secondary for you. If a claim is submitted directly to the secondary insurer, the correct procedure would be for the secondary insurer to reject the claim for the reason that the claim must be submitted to the primary insurer first.I’ve been in a similar situation when my primary insurer became secondary, and correspondingly the secondary insurer became primary. When providers who didn’t get the clue submitted to what had become the secondary insurer, the claims were rejected.The providers usually ask for both (or all) cards and ask which is primary.
How can I find a doctor that prescribes Xanax that accepts medicaid?
Is this a medication you are currently on? In this case, I would recommend finding primary care physicians or internal medicine physicians in your area that accept your insurance, and when you call to make an appointment state that you were wanting a medication consult to refill the specific medication. The office staff may be able to give you some guidance as to whether or not that physician ever prescribes that medication, or if they would be willing to do it on a short basis while they get you referred to a psychiatrist.Xanax is a medication in the benzodiazepine family. It is a scheduled medication meaning it has the potential for addiction and abuse. Most physicians do not prescribe it as routinely or as long term as they perhaps once did. It is a better medication in the hands of a specialist (a psychiatrist).In fact, I will tell you that out of all the benzodiazepines, Xanax is the one I prescribe most rarely. It has a short duration of action and a higher potential for abuse secondary to the possibility of a "high".Even when used entirely appropriately these medications can become habit-forming.You should be aware that there are other medications to successfully treat anxiety that have a lower potential for abuse and addiction. I regularly prescribe busprione or other SSRIs or SNRIs for this purpose.I do prescribe benzodiazepines on a temporary basis in the event of acute bereavement or other major life stressors. I think its utility is primarily as a temporary or very occasional measure in conjunction with other medications and therapy.I also have a handful of elderly patients that have been taking this medication for decades to help with sleep. It's actually not a great medication for maintaining sleep, but if you're 80 years old and have been taking this medicine forever you tend to get pretty irritated with the upstart doc who tries to take you off of it :)
Does secondary insurance pay deductibles and co-payments for primary insurance?
For a time my children had double coverage, and when that was the case, we never paid anything for any of our children's healthcare: whatever wasn't paid by the first policy was paid by the second. (This was a real boon when my son's neurofibromatosis was diagnosed; I have no idea how much we were charged for all the diagnostic testing or procedures he received, because we didn't pay a penny for any of it.) Apparently, the law on this requires the second policy to pay what it would had the first policy not been in place, up to whatever amount wasn't paid by the first policy, including any amount not paid because of a deductible or copayment. Also, amounts paid by the first policy still count toward satisfying any deductible of the second policy, and vice versa. None of this applies when the secondary insurance is Medicare. Medicare has entirely different rules for coordination of benefits, rules which are far less favorable to the patient or patient guarantor; in most cases what Medicare pays is reduced by any amount paid by another plan, and the patient or guarantor remains responsible for all deductibles and copays required by Medicare. (Medicare supplement insurance programs receive special treatment here, as I understand it.)Advice specific to your situation would require knowledge of the specifics of all plans available to you and your wife (coverage, limitations, premiums, etc.), and you and your wife's typical or anticipated medical expenses. You need to consider things such as services you or your wife expect might be needed that might be provided by a facility covered only by one plan or the other, the impact of in-network versus out-of-network reimbursement, and a myriad other factors.