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Coordination of Benefits

How to Get 100% Coverage

Use More Than One Plan to Maximize Your Coverage!

Do you have more than one benefit plan? Student Plan, Parent's Plan, Employer Plan or Spouse's Plan?
If so, those plans can to work together to make sure you're getting the most out of your coverage.
One plan becomes your primary plan. It pays your claims first. Then the second plan pays toward the remaining cost.

Students who have health or dental coverage through their school: these plans will always pay before any plan where the student is covered as a dependent.

Example:
A student has health coverage through the university plan, but is also still eligible under a parent's plan as a dependent.
Therefore - the school plan pays first.


This process is called coordination of benefits and it's easy to do!

IMPORTANT – Take a copy of your original receipt before you send it to your primary plan as you will need to send a copy to the secondary plan.

Submitting Claims For Yourself:
Submit the claim to your Student Plan first (this is your primary benefit plan).
Next, an unpaid portion can be submitted to your Parent's Plan, Employer Plan or Spouse's Plan (this is your secondary plan).

If you have more than one plan where you are the primary insured (Student Plan and
Employer Plan) your primary plan is the one you have had the longest.
Submit the claim to the plan you have had the longest (this is your primary benefit plan).

Next, an unpaid portion can be submitted to the plan you have had the second longest
(this is your secondary plan).



Submitting Claims for Your Spouse (if applicable):
Submit the claim to your spouse's plan first (this is their primary benefit plan).
Next, an unpaid portion can be submitted to your Student Plan (this is their secondary plan).


Submitting Claims for a Dependent Child (if applicable):
Submit the claim to the parent's plan whose birthday falls first in the year (this is their primary benefit plan).
Next, an unpaid portion can be submitted the parent's plan whose birthday falls second in the year (this is their secondary plan).



ALWAYS REMEMBER!
Include a copy of the Explanation of Benefits statement received from the first claim submission (primary plan), as well as a photocopy of the originally submitted receipt when you submit to your secondary plan.

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