What is excess medical pay? Hi, I’m Frank Nunes. I’m a California personal injury trial attorney practicing in the state of California. I want to explain to you what medical payment coverage is and then we’ll talk about the differences between standard medical payments coverage and excess medical payments coverage.
If you’re watching this video, you most likely received a letter from your automobile insurance company denying the medical bill that you submitted. They’re telling you you’re going to have to send it to your health insurance first, or provide them with proof that you don’t have health insurance.
That is the difference between standard medical payments and excess medical payments coverage. Here’s an example, one of my clients came to my office, one of his med bills that he had submitted to his automobile policy expecting it to be paid under his medical payments coverage. After all, that’s why he purchased that. He received a letter back from them refusing to even consider the bill until he had shown them proof that he had submitted it to his health insurance.
Well guess what? He didn’t have health insurance, so there was no one to submit the bill to for it to be rejected and submitted to excess medical pay. What did we do? Contacted the insurance company, explained the situation. They sent out forms. We filled those forms out and essentially the forms were testing that he had no other insurance to pay for his medical bills, except the medical payments coverage on his policy. When they got that, they started paying the bills right away.
Another example is people oftentimes have Medicaid or Medi-Cal, as it’s called in California. That is not a primary payer. That is usually a payer of last resort. It’s the equivalent, or the same thing, of not having any insurance. Again, people’s bills will be submitted and the insurance company will deny them saying, you have to submit them to your insurance company first.
We call them, like we’ve done another cases, and they say, well, the person has Medi-Cal or Medicaid. It needs to pay first, Medi-Cal and Medicaid are payers of last resort. They require that the insurance private sources pay first before they will open up their checkbook and pay anything after that.
In practicality, once the med pay pays it’s part of the bill, there’s really nothing left for Medi-Cal or Medicaid to pay. Well, that’s it for today’s video explaining excess medical payments coverage.
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And if you have questions, I want you to pick up the phone and call me since I can answer those questions. I answer questions like this every day. You can reach me at (559) 234-4712. I’m Frank Nunes and thanks for watching.
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