Which insurance is secondary to large group health plans, according to Champus/Champva rules?

Study for the Front Desk Patient Service Representative / Medical Patient Access (PSR/MPA) Test. Explore multiple-choice questions with explanations. Prepare for success in your exam!

The correct choice reflects that disability insurance is considered secondary to large group health plans when operating under the rules established by CHAMPUS/CHAMPVA. This is due to the nature of how coordination of benefits works within various health insurance policies.

Disability insurance typically provides income replacement and does not typically cover healthcare services directly. Therefore, when an individual has access to a large group health plan, that plan is responsible for covering medical expenses first because it is designed to handle the costs associated with healthcare. Once the large group health plan has processed a claim, disability insurance may then provide a secondary benefit in terms of income replacement, but it does not contribute to medical expenses.

This coordination of benefits is essential for ensuring that there is no overlapping coverage and that the insured individual receives the maximum benefit available without presenting claims to multiple insurers for the same medical expenses. In this case, large group health plans take precedence, making disability insurance secondary in terms of healthcare cost coverage.

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