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: Fri Nov 14, 2008 04:29 am Post Subject: Med Pay In Oklahoma
yikes.
Just realized how long that last post was. Sorry everyone! I can't stand to look at such long messages!!!
Have a Good Night!
Posted: Fri Nov 14, 2008 12:28 pm Post Subject:
I STILL HAVE THE SAME QUESTIONS IS YOUR MED PAY SUBROGATABLE?MEANING CAN THEY ALSO RECOUPE THE PAYMENT OF YOUR MED PAY BACK FROM THE THIRD PARTY CARRIER BECAUSE IF THEY CAN IT WOULD NOT MAKE SINCE THAT THE AT FAULT CARRIER WOULD REIMB YOUR HEALTH CARRIER WHICH I KNOW IS CORRECT FOR 1000 THEN TURN AROUND AND OWE YOUR MED PAY CARRIER 3000. JUST ASK YOUR MED PAY CARRIER IF MED PAY IS SUBROGATABLE OUT OF YOUR THIRD PARTY SETTLEMENT AS WELL
Posted: Mon Dec 15, 2008 09:59 pm Post Subject:
Posted: Mon Dec 15, 2008 09:59 pm Post Subject:
Posted: Wed Dec 02, 2009 07:59 am Post Subject: my at fault accident
I was driving my mother-in-law's truck (she has rental properties and we use it to work on them) My car was not running so with her permission i drove it to work. I ha just got off of short term disability leave from Aug-Oct and then 3 days later, on my way to work after a routine check up with my PCP, I failed to yeild from the driveway and was T-Boned at 40mph on a busy street. So, now i'm trying to understand why my disability office won't approve my Rebound short term disability claim from 11/3 to the present. I have 2 doctors who say they won't release me back to work yet. I have to have an MRI tomorrow but I feel I'm gettng better. I work for a major phone company (A*&*)
I ha permission to drive the truck that is normally parked at my house so my husband can drive it and I was informed by state farm that even though I'm at fault, I'm entitled to $5K in med pay. My doc says he's putting my mri on my health insurance.
My question is, since the truck is totaled and I've been out of income for a month, could I use any of that med pay for loss of income, pain and suffering, etc. The latter I was hoping to use as a down payment on another vehicle. Any advice?
Posted: Thu Jan 14, 2010 06:56 pm Post Subject:
Oklahoma Medpay is only subrogable for someone not on the insured policy. "a non resident relative" also. Check the state statutes regarding medpay to confirm this. I work specifically in subrogation. Basically this is the only time you can go after the "at fault" party's carrier for medpay specifically.
Posted: Mon Aug 13, 2012 11:27 pm Post Subject: Help
I got a bill from my Dr for ESI injections totaling almost 25,000. My PPO paid the bill and the total came back around 5000. So now my balance is O.OO at the Dr office. My med pa.y sent me a check for a little over 5000. I have over 100,000 in med pay insurance. Im In OK, I dont know why i wasnt paid the 25,000 and then i would reinburse my PPO the 5000. I was not at fault for this crash. Also the other thing thats a problem is both of us have USAA. Help this doesnt sound right.
Posted: Wed Aug 15, 2012 04:39 am Post Subject:
Let's try reordering your statements a little bit and see if it doesn't help:
I got a bill from my Dr for ESI injections totaling almost 25,000. I dont know why i wasnt paid the 25,000 [from my med pay insurance]. My PPO paid the bill and the total came back around 5000. So now my balance is O.OO at the Dr office.
There's the answer. Despite the $25,000 billing from the physician, his PPO contract only permits him, and he has agreed, to be paid $5,000 for your treatment. Since your "loss" was not $25,000, your med pay doesn't owe you that amount.
Too bad. We don't have that level of MedPay available in CA. $5000 tops. But, if your health insurance paid the $5000 bill, they may also be entitled to the $5000 you received from your insurance company -- that's called subrogation. The law in OK may not permit subrogation of MedPay. In CA it's considered "excess" coverage -- only pays those expenses not covered by other insurance, so it is not subject to subrogation.
Posted: Thu Aug 16, 2012 11:44 pm Post Subject: MedPay
So from what im understanding then is I have to write a check to BCBS for the 5000. If i dont that would be considered insurance fraud. Thanks I will make sure I pay them. So how does this double dipping work because I guess its legal in OK. Also is this subrogation agaist me or will BCBS get more money from USAA the party responsible. Also on another note this is going to seriously effect my settlement down the road. Also my dr wrote off 15,000 in cost because were friends. does the at falt party subrogate that at all?
Posted: Fri Aug 17, 2012 12:29 am Post Subject:
If i dont that would be considered insurance fraud.
NO! I did not say that at all. There is no discussion of insurance fraud here. And it's entirely an insurance company's choice to subrogate a claim or not. It has nothing to do with you or the at fault party at all.
Subrogation, if even allowed against MedPay, only permits a health insurance company to recover what it actually paid to its contracted providers. If they paid $5000 on a $20,000 bill, they can only collect $5000 through subrogation. Not one penny more. They have no other loss.
I can't say for certain whether Oklahoma permits subrogation on MedPay or not. One website I have seen suggests that subrogation is only available against the claims of "guest passengers" in your vehicle. So if that's correct, then you have nothing to repay to BCBS. And they have nothing to subrogate against as far as MedPay is concerned.
By the same token, you cannot simply collect the difference between what was billed and what your health insurance company paid its providers and your MedPay policy limit. That would be a "problem" for you.
Now, when you ask about a civil action against the at fault party, then you introduce a new element. Doctors, but not hospitals, apparently have the right of subrogation against legal judgments/settlements for liens they place on persons who do not pay their bills. If you were to get a settlement under such circumstances, you might have to give the doctor some of your settlement money (but if your doctor was paid their agreed fee by your insurance company, then their right of subrogation is gone, too). See the article from the Oklahoma Bar Association I found here: http://www.okbar.org/obj/articles08/080908starr.htm/
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