Make the Most of Your Coverage - Understanding Coordination of Benefits

Choosing to include dependents, such as a spouse or children, as part of your health benefits coverage through ASEBP provides you and your loved ones protection from the full cost of health care expenses.  It might also give you the opportunity to make the most of other coverage your dependents have and thereby reduce your out-of-pocket expenses for things such as prescription drugs, dental care, eye glasses and more.

Submitting claims in this way (i.e. to more than one benefit plan or carrier) is sometimes referred to as “Coordination of Benefits” and it is a great way to maximize health-benefits coverage and potentially re-coup all of your out-of-pocket expenses. Remember that each carrier’s normal maximums and fee schedules apply and you will never receive more than the actual cost of the product or service. Understanding how this process works is easier than you might think.

Please review each example and keep in mind that family coverage applies only to health-related benefits (as opposed to income replacement benefits such as Extended Disability and Life Insurance). After you review the examples, if you still have questions, please feel free to contact us - we'd be happy to help.

Coordination of Benefits Examples
	Claims for ASEBP Member vs. Non-ASEBP Member (Extended Health Care)
	Claims for Dependent Children (Vision Care)
	Dental Care Claims and The Dental Benefit List
	Claims for People Age 65 and Over

Please Note: Beginning September 1, 2004, claims that are first sent to ASEBP when another carrier should be paying first will be returned to you for submission under the other plan.  Once the other carrier has paid its portion, any unpaid balance can be submitted to ASEBP.