Coordination of Benefits

What is Coordination of Benefits (COB)?

Coordination of Benefits is a way that insurance companies work together to make sure they don’t both pay for the same medical bill. If a person has more than one health insurance plan, COB decides which one pays first and how the other one helps after that.

Why is this important?

Without COB, the two insurance companies might both try to pay for the same bill, or they might both refuse to pay until the other does. COB helps organize everything so the bill gets paid correctly and fairly.

Example:

Let’s say you have two insurance plans:

• One through your job (primary insurance)

• One through your spouse’s job (secondary insurance)

Here’s how it would work:

1. Your primary insurance (your job’s plan) pays the bill first.

2. Then, your secondary insurance (your spouse’s plan) looks at what’s left and might pay part or all of the rest, depending on the coverage.

You can’t get paid more than the bill costs, but you might end up owing less out-of-pocket.

What do I need to do?

If you have more than one plan:

• Let your insurance companies know about the other coverage.

• Fill out any COB forms they ask for.

• Always show both insurance cards when you go to the doctor.

Important:

• COB doesn’t double your benefits,  it just helps make sure the bills are paid in the right order.

• If you don’t report both coverages, it could delay payment or cause your claims to be denied.