Coordination of Benefits
Related FAQs
How do you determine which health insurance plan is primary?
This is referred to as 'Coordination of Benefits'. While there are a number of different possible scenarios, the most common is when a couple is covered under two separate plans.
In such a scenario, you will always submit claims in the following sequence:
1. Your own benefits plan first.
2. Your spouse’s plan (for any remaining unpaid amounts from step 1 above). Likewise, your spouse’s claims should be submitted to their own plan first.
A full blog post going deep on this subject can be found here: https://aeva.ca/blog/what-is-coordination-of-benefits
In such a scenario, you will always submit claims in the following sequence:
1. Your own benefits plan first.
2. Your spouse’s plan (for any remaining unpaid amounts from step 1 above). Likewise, your spouse’s claims should be submitted to their own plan first.
A full blog post going deep on this subject can be found here: https://aeva.ca/blog/what-is-coordination-of-benefits
Can you have two separate health insurance plans?
It's not unusual to have multiple health insurance plans.
You can be covered under both an employee group benefits plan and an individual health insurance plan. If you have multiple plans, you would submit your claims sequentially. For instance, you would file a claim with one plan first, then submit the remaining balance to the second plan.
However, it's important to note that you cannot claim the full amount of the same expense twice.
You can be covered under both an employee group benefits plan and an individual health insurance plan. If you have multiple plans, you would submit your claims sequentially. For instance, you would file a claim with one plan first, then submit the remaining balance to the second plan.
However, it's important to note that you cannot claim the full amount of the same expense twice.