Wiki Insurance conundrum

kobrien

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I have a student who has partial custody of a minor and court ordered health insurance. The major custodial parent has Medicare for the same minor. I have never heard of this before. Is this legal?
 
What is the court ordered insurance, isn't it a "secondary"? The parent has a right to have the Medicare coverage and it be appropriate for anyone under any circumstance to have a secondary insurance. Is it the best interest of the child to have a second insurance due to major medical expenses that would be a burden to your student helping to care for this child? I would also think that if it is court ordered it would have to be legal. My biggest hope though and it sounds like it is, is that the child is being well taken care of and someone is advocating for his/her needs. On behalf of the child, thank you.
 
How it works

I'm going to have to disagree with the prior response. This is how it works:

Medicare is coverage provided to someone that is disabled or 65 (or both). It is not coverage that either parent has on the child, it is something determined by the government and stays with them for the rest of their life (unless they are no longer disabled). So this child apparently has a disability. Part A is automatic, and covers inpatient, hospice, and SNF care. Part B is something they can choose to have or not have, and they pay a premium for the coverage. Most medical care is through Part B.

If there is court-ordered insurance, it is going to be through an employer plan. Unless the employer has less than 50 employees, the employer insurance will always be primary. If it is a very small employer, say 10 employees, then the Medicare can be considered primary. Here is a link to a Medicare publication that explains it: https://www.medicare.gov/Publications/Pubs/pdf/02179.pdf

If this child has Part A but not Part B, they essentially don't have medical benefits for physicians, diagnostic studies, surgeries, etc. In that case, the employer insurance would be the only coverage, and they would be responsible for the balance after the employer plan.

When someone has Medicare secondary, they almost never have a balance to pay. Medicare decides what it would have paid if it were primary. If the employer insurance already paid that much or more (which they usually do), Medicare says they are not responsible for anything further, and you can't bill the patient either.
 
We are all assuming many things here and really can't give a correct answer without all the facts.

As I stated in my first post though, if it is court ordered wouldn't one assume it must be legal?

Why does the minor have Medicare and what type?
What state is this patient in?
What is the court ordered insurance and why is it court ordered?
Who is responsible for providing the court ordered insurance?

Then you can answer the question posed.

First though who is asking the question, your student or you?
 
It is my understanding that medicaid is payer of last resort. If the patient has any other insurance it must be billed 1st. There are a few exceptions to this but not many. I would contact your local state medicaid provider for clarification in this situation.
 
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