A health plan referred to as the "payer of last resort" is typically which of the following?

Prepare for the Certified Billing and Coding Specialist Exam. Improve your skills with multiple choice questions; each question comes with hints and explanations. Get confident for your exam!

Medicaid is known as the "payer of last resort" because it is designed to cover medical expenses only after all other available resources, including private insurance, Medicare, and employer-sponsored insurance, have been exhausted. This means that before Medicaid will pay for a person's healthcare costs, the individual must first utilize any other insurance they might have. This characteristic is crucial because it helps to ensure that Medicaid funds, which are limited and intended for individuals with the greatest need, are used appropriately and not as the primary source of payment.

Other types of insurance, such as Medicare, private insurance, and employer-sponsored insurance, may provide primary coverage and are expected to pay for services before Medicaid is considered. This structure ensures that Medicaid serves as a safety net for those who are underinsured or uninsured, thereby minimizing unnecessary spending on services that other insurance plans can cover.

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