Wiki deductible question

[MDColbert]

If a pt has medicare, UHC, Anthem, etc as primary and Caresource medicaid, Molina medicaid, straight medicaid, etc for secondary ins, is the pt responsible for deductible when they are see a nurse practioner?

 

[danskangel313]

If a pt has medicare, UHC, Anthem, etc as primary and Caresource medicaid, Molina medicaid, straight medicaid, etc for secondary ins, is the pt responsible for deductible when they are see a nurse practioner?

For a Medicare patient with Medicaid, payment of the deductible will depend on the type of dual eligibility they have.

For a non-Medicare patient with Medicaid, it varies by state and by Medicaid program as to whether Medicaid will pay or if the patient will be liable for a primary insurer's deductible.

If you're asking whether or not a deductible applies when an NP bills charges, that would be plan specific to the primary payer, but likely they will be considered the same as any other provider type.

It's also worth mentioning that certain services may not be counted into a patient's deductible by a payer. For example, an office visit versus an inpatient stay.