If a patient has Medicare Part A only and has Provident medical insurance, which one is primary?

If a patient has Medicare Part A only and has Provident medical insurance, which one is primary?

• A. Medicare Part A
• B. Provident
• C. Medicaid
• D. Both are equal

Answer: (B)

In a situation where a patient has Medicare Part A and also has a private insurance plan like Provident, the determination of which insurance is primary largely depends on specific coverage rules. Under standard coordination of benefits guidelines, if a patient has both Medicare and private insurance, the private insurance typically acts as the primary payer. This is because Medicare Part A primarily covers hospital inpatient services, while the private insurance may provide broader coverage for outpatient services, and could also fill in gaps that Medicare does not cover. In essence, when a patient has access to benefits from both Medicare and a private insurance provider, the private insurance is likely to be billed first for any services rendered, making it the primary payer. Thus, in this scenario, the correct answer is that Provident is the primary insurance.

In a situation where a patient has Medicare Part A and also has a private insurance plan like Provident, the determination of which insurance is primary largely depends on specific coverage rules. Under standard coordination of benefits guidelines, if a patient has both Medicare and private insurance, the private insurance typically acts as the primary payer.

This is because Medicare Part A primarily covers hospital inpatient services, while the private insurance may provide broader coverage for outpatient services, and could also fill in gaps that Medicare does not cover. In essence, when a patient has access to benefits from both Medicare and a private insurance provider, the private insurance is likely to be billed first for any services rendered, making it the primary payer. Thus, in this scenario, the correct answer is that Provident is the primary insurance.