Coordination of Benefits
Coordination of benefits (COB) is a crucial process in health insurance that ensures patient families don't receive duplicate payments for covered services when they have multiple plans. COB rules determine which plan is "primary" and how much each plan contributes to covering expenses. This occurs when there is additional health insurance coverage through your spouse, another employer or a government-sponsored program (Medicaid, Medicare or Medical Assistance).
Why is Coordination of Benefits important?
Reduces your out-of-pocket costs
By preventing duplicate payments for the same medical services, COB ensures you don't get stuck with unexpected bills.
Increases transparency
By clarifying which plan is responsible for what, COB helps patient families understand their benefits and make informed decisions about their healthcare expenses.
Ensures complete coverage
COB ensures you receive the full benefits you're entitled to from all your plans, maximizing your coverage.
Avoids confusion and delays
By clarifying which plan pays first, COB prevents delays in receiving care or reimbursements.
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How do I complete Coordination of Benefits?
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How do I contact my insurance company regarding coordination of benefits?
Your insurance company may have different methods for contacting them regarding coordination of benefits. The most common methods are by phone, online portal, mail or fax.
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What happens if I do nothing?
If the coordination of benefits status is not updated, it is possible your insurance company will refuse to pay any claims. They may identify the amount owed as patient responsibility, leaving you with the full balance for your visit(s). Complying with your insurance company’s coordination of benefits request will save you time and prevent confusion between you, your insurance company and healthcare provider.