I have two insurances, first one pay's fee for service my secondary which is my wife's is capitated do I still pay my copay?
Total Comments: 1
Posted: Tue May 04, 2010 01:46 pm Post Subject:
Your primary insurance sounds like a PPO or POS policy (or possibly a traditional major medical policy), while your wife's coverage sounds like an HMO. You would normally be required to use your primary coverage before considering the use of your secondary coverage.
This is particularly true when "out of network" services are involved. Copays are copays. Money paid to a service provider at the time of service, which does not affect the claims payment from the insurer to the provider.
After paying your copay, if your primary insurance did not cover some or all of a particular expense, you could then submit the unpaid portion to your secondary insurance for payment, if covered by that policy. The secondary policy would not have you make another copayment to the service provider, it would only be concerned with the billable amount of a service.
Posted: Tue May 04, 2010 01:46 pm Post Subject:
Your primary insurance sounds like a PPO or POS policy (or possibly a traditional major medical policy), while your wife's coverage sounds like an HMO. You would normally be required to use your primary coverage before considering the use of your secondary coverage.
This is particularly true when "out of network" services are involved. Copays are copays. Money paid to a service provider at the time of service, which does not affect the claims payment from the insurer to the provider.
After paying your copay, if your primary insurance did not cover some or all of a particular expense, you could then submit the unpaid portion to your secondary insurance for payment, if covered by that policy. The secondary policy would not have you make another copayment to the service provider, it would only be concerned with the billable amount of a service.
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