How to
File a Claim

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What is secondary medical coverage?

Pre-Med Defender is supplemental, or secondary, medical insurance coverage that individuals use together with their primary care/major medical plan (typically a high-deductible health plan). Pre-Med Defender pays for things like deductibles and other out-of-pocket expenses.

Understanding the Two-Card System for Claims

Using Pre-Med Defender involves two forms of coverage and two different payer IDs. Members will have a separate ID card for each policy. When visiting a medical provider, they will present BOTH cards.

card1

Primary Major Medical Plan

card2

Pre-Med Defender Secondary Plan

Pre-Med Defender Claims Process

STEP 1: Provider files claim with the Primary Insurance Carrier

STEP 1: Billing the Primary Insurance Carrier

Members present both ID cards to the medical provider at the time of service.

Notes To Members: This is ALL you have to worry about! You may, however, receive a bill from your provider for any balance that remains once both your primary policy and Pre-Med Defender are billed.

Providers: Should automatically send primary coverage claims information electronically for processing. Once the primary insurance carrier pays their portion of the bill, the provider will receive an EOB from the primary carrier.

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STEP 2: Provider files claim with the Secondary Insurance Carrier

STEP 2: Billing the Secondary Insurance Carrier

Once the healthcare provider receives the Primary Carrier EOB, they then submit the secondary claim electronically, by fax, or by mail. Claim mailing address, phone number, and EDI Payer ID is located on the back of the member’s ID card.

Note to Providers: Secondary claims must include a copy of the primary insurance EOB and claim form (UB92 or HCFA 1500).

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STEP 3: Secondary Claims Are Then Paid Directly to the Provider

STEP 3: Claims Are Then Paid Directly to the Provider

Members present both ID cards to the medical provider at the time of service.

Providers: Any remaining balance for services rendered that was not covered by either the primary policy or Pre-Med Defender should be billed to the member at this time.

Members: You may receive a bill from your provider for any remaining balance that was not covered by either policy. Reach out to the provider with any questions or concerns!

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Have questions about claims?

Contact Pre-Med Defender now at (866) 972-2368 or simply fill out the brief form below.

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