by Guest » Wed Nov 12, 2008 03:36 am
HI all,
What a great forum! Glad I found you.
I'm very new to this type of communication, so treat me with 'kit' gloves!
Does anyone know off-hand if Oklahoma is a so called "double dip" Med Pay state?
My insurance company is telling me "yes", and that I have non-reimburseable med-pay... but we want to be sure.
Family (4 of us) were 'flipped' over at 75mph on the turnpike by a drunk driver. Glad to be here to be able to even ask this question! Lots of 'soft-tissue' pains, wife may have to have knee surgery, our 11yr old son, who had brain surgery in June, sustained a pretty good concussion (we'll have to monitor to make sure he doesn't have any bleeding on his brain)
Thank you very much for your time!
What a great forum! Glad I found you.
I'm very new to this type of communication, so treat me with 'kit' gloves!
Does anyone know off-hand if Oklahoma is a so called "double dip" Med Pay state?
My insurance company is telling me "yes", and that I have non-reimburseable med-pay... but we want to be sure.
Family (4 of us) were 'flipped' over at 75mph on the turnpike by a drunk driver. Glad to be here to be able to even ask this question! Lots of 'soft-tissue' pains, wife may have to have knee surgery, our 11yr old son, who had brain surgery in June, sustained a pretty good concussion (we'll have to monitor to make sure he doesn't have any bleeding on his brain)
Thank you very much for your time!
Posted: Wed Nov 12, 2008 11:08 am Post Subject:
Oh Bow, so glad it ended out a happy story, I don't have to tell you people die in a lot less severe accidents...
My insurance company is telling me "yes", and that I have non-reimburseable med-pay... but we want to be sure.
If you are worried have them put it in writing...the state I'm in (MO) is also a double dip state...now remembering that has nothing to do with your health carrier's subrogation rights, assuming they have paid, but they should get that back from the 'guilty' party's policy if there is enough...I'm not sure if your health carrier can demand your medpay but I don't think they can, I think they can only go after the BI settlement again this is something to ask your health carrier...I would assume you have BI claims on all of you with the drunk driver...how are his/her rates? High enough to cover you all?Posted: Wed Nov 12, 2008 11:11 am Post Subject:
It seems that Oklahoma encourages double dipping on medpay, that is that you can collect both under your plan as well as the other driver's insurer for the same medical expenses. Great, isn't it?? :D
However, just confirm it with the insurance department.
Posted: Wed Nov 12, 2008 12:40 pm Post Subject:
Sure glad to see a good turn out. In the states that can Subrogate med pay who is actually entitled? Is it just your private health care insurance or can your auto come back and request the med pay be repaid even though you paid to have that coverage on your policy. I keep hearing different versions.
And Bow...You did excellent wiht this type of communication!
Posted: Wed Nov 12, 2008 01:30 pm Post Subject:
ACCORDING TO MY INFORMATION OKLAHOMA CAN SUBROGATE THE MED PAY OUT OF ANY THIRD PARTY SETTLEMENT
Posted: Wed Nov 12, 2008 01:59 pm Post Subject:
So J you're saying that the medpay provider (insured 1st party) CAN subro the BI carrier? In OK?
Posted: Wed Nov 12, 2008 02:03 pm Post Subject:
according to my information yes. just ask the med pay carrier. if they say they will not be subrogating the med pay get in writing and move forward with the settlement once treatment is complete
Posted: Wed Nov 12, 2008 04:45 pm Post Subject: Thank you
Thanks to all for taking your time to educate me!
The latest advice we've been given (from a dear family friend and Oklahoma attorney... yes, there are some good ones out there)
"Have your health insurance co. handle the medical bills. They then will subro the "at-faults" insurance company. Provide your AUTO insurance with a copy of the medical bills and they will send you your med-pay benefit".
Sound consistent?
Again, THANK YOU ALL.
Posted: Wed Nov 12, 2008 04:57 pm Post Subject:
STILL DONT SEE WHO IS PAYING BACK THE MED PAY CARRIER OR IS THE MED PAY NOT SUBROGATABLE IN OKLAHOMA?
Posted: Wed Nov 12, 2008 06:20 pm Post Subject: Med-Pay
Thanks J,
That's the question I guess I really need to follow up on.
Posted: Fri Nov 14, 2008 04:25 am Post Subject: Med Pay In Oklahoma
Thanks again ya'll for your time and expertise.
I'm still somewhat naive on all of the terminology, but here's my latest understanding of my situation re: Med-Pay in Oklahoma.
Our Med Pay limit is $5k per person. And we have UM insurance to cover whatever we need over our limits of Med Pay (to a point)
STEP 1) We need the services of medical providers for our injuries.
STEP 2) We use our health insurance (HMO) and pay our co-pay. HMO
pays the health providers. (WHATEVER THEY HAVE NEGOTIATED
payment to be.) It doesn't matter to us what that amount is....
Because we've paid for our health insurance coverage thru work
with each paycheck and our Med Pay as part of our vehicle
insurance payments. Actual payment amount to health care
providers is irrelevant.
STEP 3) Our HMO provides us with an invoice for WHAT THE EXPENSE TO
US WOULD HAVE BEEN IF WE DIDN'T HAVE INSURANCE. The
health care provider has been paid by our HMO for WHATEVER
THEY AGREED ON.
STEP 4) We forward this TOTAL invoice to OUR auto MED PAY. Our auto
insurance company sends us payment for the invoices
A) This is the benefit of the "double dip" which we don't
feel 'right' about, but are told it's 'customary' and legal.
Maybe we'll just donate any excess to charity.
STEP 5) We forward this same invoice to "at faults" insurance for
inclusion in our BI settlement.
-----When we settle with "at faults insurance" we pay back our HMO
for the AMOUNT THEY ACTUALLY PAID on our behalf.
Ie. If the invoice we submitted to "at faults insurance" was for an MRI for $800, but our HMO actually paid $400, we pay back our HMO the $400. We 'come out ahead' $400. Or, the Salvation Army comes out ahead $400.
EXAMPLE: My wife has to have surgery on her hip. Total cost of the procedure is $3,000. Our HMO "covers" the cost of the surgery. While our HMO may have a deal with the doctor paying only $1000, we will submit the total cost of the surgery $3000 to both our Med Pay provider and the "at faults insurance". We'll receive the $3,000 from our Med Pay; AND When we 'settle', we owe our HMO $1000 from our settlement. We get $3,000 'benefit' from our Med Pay, and the Salvation Army gets two grand.
Did I hit my head harder than I remember? OR, am I on the right track with this?
Thanks again
"Bow"
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