We have two insurance policies! Now what?

Coordination of Benefits (COB) is a process used by insurance companies to determine the payment responsibilities when a person is covered by more than one health insurance plan 

If you use coordination of benefits for health insurance, the primary insurance pays its share of your health care costs first. Then, the secondary insurance plan will pay up to 100% of the total cost of health care, as long as it’s covered under the plan. Neither plan will pay more than 100% of the total health care costs, so you won’t get double the benefits if you have multiple health insurance plans. 

Simply put the answer is YES!!!  If you have Medicaid and another commercial plan you must tell us!  To omit this information can be considered Medicaid Fraud and is reportable to Florida Medicaid.

Coordination of Benefits for People who have Private Health Insurance and Medicaid

• You must inform the office that you have both insurances. 
• Failure to notify the office of both policies will result in claims not being      paid.
• If a claim is not paid you will be held financially responsible for the entire amount of the bill. 

Coordination of Benefits for People who have two Private Health Insurances

• You must inform the office that you have both insurances. 
• Failure to notify the office of both policies will result in claims not being      paid.
• If a claim is not paid you will be held financially responsible for the entire amount of the bill

Coordination of Benefits

• Each year you may receive a coordination of benefits letter/email to verify if you or your eligible dependents have obtained or will obtain other medical insurance coverage. 
• It is important to keep your COB information current to avoid a delay in claims processing. 
• If you receive a COB letter, fill it out and return it immediately, or you can update your COB information on the insurance companies web site.
• Failure to answer this letter can result in a denial of claims. 
• If a claim is denied due to you not answering the COB letter, you will be held      responsible for the entire amount of the bill.

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