How does coordination of benefits work?

Coordination of benefits is a process used to ensure that the total healthcare expenses of individuals with multiple insurance coverage are shared fairly among insurers. When an individual has medical coverage from more than one insurer, coordination occurs to determine the primary and secondary insurers. The primary insurer pays the healthcare expenses first, while the secondary insurer covers the remaining costs. This process prevents overpayment or duplicating benefits. The primary insurer can be identified using rules defined by Medicare, such as whether the insurance is based on current employment or beneficiary status. Once the primary insurer has paid, the secondary insurer determines its responsibility based on the remaining expenses. It is important to provide accurate and complete information to insurers for effective coordination of benefits and to ensure appropriate coverage for medical services.