Arizona Health Insurance Coordination of Benefits

There are several other types of insurance policies that pay for medical claims other than an individual Arizona health insurance policy or employer group health policy. Auto insurance, homeowner’s policies, malpractice policies, and workman’s compensation plans all pay for medical expenses depending on the situation. It is possible that an individual’s health insurance policy will coordinate benefits with other policies, again, depending upon the situation.

When multiple insurance policies are responsible for paying a portion of a claim “Coordination of benefits” (COB) kicks in. Insurance companies use COB to determine who pays first, and how much.

Another example of COB in action is when a child is covered by both parent’s employer health insurance plan. If the child has a claim the two insurance companies will use what’s known as the birthday rule. Whichever parent has a birthday earlier in the year will be the primary insurer, the other parent’s policy becoming secondary coverage. The days of double coverage being the norm have long passed, but occasionally such situations still occur.

Often an insurance company will require that a policyholder with an orthopedic or radiology claim fill out a form if medical services are associated with an accident of some sort. The form will ask for details about the accident and whether another insurer is possibly involved. A slip and fall at the local grocery store will likely result in your health insurer giving the store a call for their insurance information to coordinate benefits.

It is important to know what medical benefits your auto insurance policy covers, as such benefits will likely be tapped when involved in an auto accident. The auto and health insurers of all involved with coordinate benefits.