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Insurance

Can You Bill Secondary Insurance for Copay?

Having multiple health insurance plans can get confusing when it comes to who pays what. Specifically, many wonder if they can use their secondary insurance to cover copays required by their primary insurer. Unfortunately, the coordination of benefits rules do not allow billing a secondary plan for the primary’s copay. This article provides an overview … Read more

Does Co Insurance Apply to a Total Loss?

Co insurance is a common clause in many property insurance policies that requires the policyholder to carry a certain amount of insurance coverage relative to the total value of their property. If the insured does not maintain adequate limits, they may be penalized through co insurance in the event of a claim. This article explores … Read more

What Are the Six Models of Managed Care?

Managed care refers to a variety of methods and systems that are intended to control healthcare costs and utilization. There are several different managed care models that organize provider networks, member services, and reimbursement approaches in order to manage the cost, quality, and access to healthcare. The six main types of managed care models include: … Read more

Can My Employer Ask About My Spouse’s Health Insurance?

It’s becoming increasingly common for employers to inquire about a spouse’s access to health insurance. With rising healthcare costs, some companies are looking to trim expenses by limiting coverage for spouses who could get insurance through their own job. So can your employer actually ask about your spouse’s insurance when you enroll in workplace benefits? … Read more

How Does Insurance Determine the Allowed Amount?

When you receive medical care and file a claim with your health insurance company, you may notice that the amount your provider charged doesn’t match what your insurance paid. This difference is due to the allowed amount set by your insurer. The allowed amount, sometimes called the eligible expense, is the maximum dollar amount an … Read more

Can I Self-Insure My Home?

Self-insuring your home means foregoing traditional home insurance and instead using your own money to cover any losses or damages. While self-insuring may seem like a way to save on insurance premiums, it carries significant financial risks that make it impractical for most homeowners. What is Self-Insuring a Home? Self-insuring your home means you have … Read more

Is Medicare a Third-Party Payor?

Medicare is indeed a third-party payor for healthcare expenses. As one of the largest public health insurance programs in the United States, Medicare covers over 60 million Americans aged 65 and older and younger people with certain disabilities. When people with Medicare receive medical care, Medicare pays most of the bill directly to healthcare providers, … Read more