So my roommate got into a car accident October 2020, and I don't know much about PIP coverage because I handle workers' comp (quite different from auto, and I feel as if Geico makes up its own rules based on what my roommate tells me). Anyway, I'm trying to help her out here.
Car accident back in October 2020. Extent of RM's medical treatment: fractured shoulder, ambulanced to the ER on scene, had surgery with hardware implants (not in the ER, though), a few follow-ups with the ortho surgeon, physical therapy.
For 2020, RM was covered by Amerihealth HMO for health insurance. She was temporarily on Medicaid (Horizon NJ Family Care) for January 1,2021 but has since been back with Amerihealth effective February 1, 2021.
Private health insurance (Amerihealth) was always primary regardless of what her health insurance was, and PIP ($15k limit, bare-minimum policy, no reimbursement for lost wages in my policy) has picked up the remainder. (RM is unsure, but I get the feeling she incurred well-beyond her limit.)
Now, my RM's and my question is about coverage issues. January 2021, RM had to switch to Medicaid. Questions regarding this:
1. Would Amerihealth still be the primary insurance for medical (since that was what I had started with) for any dates of service in January 2021 (while on Medicaid)?
2. If the primary health insurance does have to change going for January 2021: in NJ, Medicaid cannot be used as her primary for this car accident, correct? It has to be secondary? (I believe it is but neither of us is not that knowledgeable in NJ auto-insurance/PIP.)
a. So while on Medicaid, would the primary insurance for medical be her PIP?
b. (RM and I think it's been exhausted at this point, but if not....) Would her auto PIP take over as primary and cover the bills incurred during January 2021 if she's at her policy limit?
Car accident back in October 2020. Extent of RM's medical treatment: fractured shoulder, ambulanced to the ER on scene, had surgery with hardware implants (not in the ER, though), a few follow-ups with the ortho surgeon, physical therapy.
For 2020, RM was covered by Amerihealth HMO for health insurance. She was temporarily on Medicaid (Horizon NJ Family Care) for January 1,2021 but has since been back with Amerihealth effective February 1, 2021.
Private health insurance (Amerihealth) was always primary regardless of what her health insurance was, and PIP ($15k limit, bare-minimum policy, no reimbursement for lost wages in my policy) has picked up the remainder. (RM is unsure, but I get the feeling she incurred well-beyond her limit.)
Now, my RM's and my question is about coverage issues. January 2021, RM had to switch to Medicaid. Questions regarding this:
1. Would Amerihealth still be the primary insurance for medical (since that was what I had started with) for any dates of service in January 2021 (while on Medicaid)?
2. If the primary health insurance does have to change going for January 2021: in NJ, Medicaid cannot be used as her primary for this car accident, correct? It has to be secondary? (I believe it is but neither of us is not that knowledgeable in NJ auto-insurance/PIP.)
a. So while on Medicaid, would the primary insurance for medical be her PIP?
b. (RM and I think it's been exhausted at this point, but if not....) Would her auto PIP take over as primary and cover the bills incurred during January 2021 if she's at her policy limit?
