What is coordination of benefits (COB) and how does it determine which plan pays first when you have multiple coverages?

• A. COB is the process of determining the order in which multiple health plans pay for a single claim; typically the primary plan pays first, the secondary plan covers remaining costs according to plan rules.
• B. COB merges two plans into a single payer.
• C. COB eliminates deductible requirements.
• D. COB only applies to dental plans.

Answer: (C)

Coordination of benefits is the process used to determine which health plan pays first when you have more than one source of coverage. In practice, one plan is considered the primary payer and covers eligible costs first, up to its allowed amount, while the secondary plan covers remaining eligible costs according to its own rules. This system helps prevent double payments and duplication of benefits.

This concept does not merge plans into a single payer, nor does it eliminate deductible requirements. Each plan’s deductible, copays, and coinsurance still apply as defined by that plan. The secondary plan may help with costs the primary plan doesn’t cover, but it depends on the specific plan terms. Also, coordination of benefits isn’t limited to dental plans; it applies to many types of health coverage.