Wednesday, May 20, 2009

If someone has two health insurance coverage, how does coordination of benefits work


If someone has two health insurance coverage, how does coordination of benefits work?
My friend was in an auto accident, and the health insurance from the auto insurer is her primary health insurance for the accident. She also has regular health insurance from another company. If the auto insurer pays 80% of her auto accident medical costs, and her secondary insurance normally pays 70% of her medical costs, then how would the secondary insurance treat a $1000 bill, for example? The auto insurer pays $800 of the $1000 bill (80%), but how much would the secondary health insurer pay?
Insurance & Registration - 3 Answers
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1 :
Health Ins will always pay their allowed amount they have for that service after deductables and copays are met. Your secondary ins works the same way.but should pick up the remainder of the bill if your ded and copay are met with them. Always look at the allowed amount for that service if the Physician is not in their network then it was your choice not to go to a provider in the insurance network and therefore the provider can collect from you the uncovered amount if they informed you that they were not a provider for that insurance company prior to your appointment. What ever their car insrance worked out with your company with your consent is how the bill should be paid. Check out this site to find the best health insurance just in one minute, http://best-free-health-insurance-quote-usa.blogspot.com/ Here you can get free quotes from different health insurance companies in your area, its the best way to find an afforable health insurance with a reliable company. Best Wishes,
2 :
Your auto coverage will pay its share and the other health insurance will pick up the balance. In your example, the secondary health insurer would pay $200, Your friend will not receive the overage, but the bill will be paid in full.
3 :
The car insurance should pay it all. It is their duty to "make claimant whole" . If insurer does not pay all of the bill, too bad for the provider. Gotta watch out for hospital and doctor scammers- they are supposed to take what the insurance pays as payment in full. But some go ahead and bill the patient for the balance. IF the car insurance does not pay it all and you get billed for the balance, contact your states Department of Insurance and file a complaint. DO NOT sign any thing from the insurance company until all bills are paid in full. I finsuracne does not pay and you get billed you need to be able to sue the driver who caused your injuries



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