Which type of insurance is typically regarded as the payer of last resort?

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 recognized as the payer of last resort because it is designed to assist individuals with limited income and resources in covering healthcare costs. This means that before Medicaid will provide payment for medical expenses, all other forms of insurance or financial assistance must be exhausted. This principle ensures that Medicaid serves as a safety net for those who truly need it after other available resources have been utilized.

For example, if a person has access to a private insurance plan or is eligible for Medicare due to age or disability, those sources of coverage must be billed first. Only after they have processed the claims and if there remain outstanding costs, will Medicaid step in to cover those additional expenses. This approach helps to manage costs within the Medicaid program and ensures that it supports individuals who might not have any other means of paying for their health services.

The other options represent forms of insurance that may not follow this same priority for payment lineage. Medicare, for instance, is primarily a payer for individuals over 65 or those with certain disabilities, and its payments can supplement other insurance programs rather than being a last resort. Similarly, private insurance often pays claims according to the policy agreements and does not operate under the same constraints as Medicaid. Workers' compensation is specific to job-related injuries and also

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy