by rwing_66 » Fri Oct 17, 2008 09:07 pm
I was in a car wreck 3 months ago (not at fault), have been in continual treatment. Doctor told me today I need surgery from a neck injury in the accident. Doctor's office is afraid to do surgery since my health insurance company has paid all of my medical bills. They think the insurance company will refuse to pay the bills once they find out it was a car wreck...but I told them this was a wreck. Could this be a possibility? I submitted these to my health insurance since I don't have the money out of pocket to pay these bills until we settle. Could be years from now. Thanks.
Posted: Sat Oct 18, 2008 12:55 am Post Subject:
It's been while since I read a health policy but I think it only states that it's excess over other (auto) insurance. If no auto insurance then they should pay. However, they _do_ have a right to recover their expenses if/when the other carrier pays you for the loss.
You or your doctors office can simply ask your health carrier if they will provide coverage. Your doctor can even pre-certify the procedure to determine what coverage is available (most carriers will do this).
Posted: Sat Oct 18, 2008 01:06 pm Post Subject:
Thats how it is here in PA Tscope. It threm me a little in the beginning. After an accident they go against what ever medical you carried on your own insurance. Once that is exhausted..you have to get an exhaustion of benefits statement sent to your own Health insurance company before they will pick up the bills. So you probaly should have made them aware this was an auto accident.
Up until the time you settle with the other drivers insurance com. you have to pay any deductible that your health insurance has and any co-pays. They tell you to keep track of the amounts you pay and sometime later you And your health provider will be reimbursed..and yes it could be a while. Hope evrything works out Rwing.
Posted: Tue Oct 21, 2008 06:05 am Post Subject:
Good info guys :D rwing, most of the health insurance providers may require the auto insurance carrier to offer the coverage initially since the injuries were due to auto accident. In such circumstances the auto health coverage will act as the primary coverage for you. The health insurance provider may come to the picture once you exhaust the limit available with the auto policy.
However, depending upon the nature of the health plan you can also file the claim directly with your health insurer. You may need to check out with the health policy to know the actual fact, but with all probabilities you may receive the compensation from the health insurer.
The health policy, however, may not compensate for the wage loss and pain and suffering. It'll cover only the medical expenses. Hope it helps.
~Jeremy
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