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Coordination of Benefits | FAQ

Learn how to ensure you have the proper coverage when you have more than one health insurance plan.

Updated over a year ago

What is coordination of benefits?

Coordination of Benefits (COB) is a process that comes into play when you have more than one health insurance plan. It helps ensure that your medical expenses are properly covered when multiple insurers are involved.

How do primary and secondary insurance work together?

Your primary insurance pays first, and your secondary insurance covers costs that your primary plan doesn't. COB prevents overpayment by insurers and ensures you receive the maximum benefits available to you.

How is primary and secondary insurance determined?

Generally, these guidelines are used when determining primary and secondary insurance:

Situation

Primary

Secondary

You’re under 26 and covered by your school or employer’s and your parent’s health plans.

School- or employer-sponsored coverage

Parents’ coverage

You’re under 26 with married parents, and both parents cover you under their separate policies.

The parent whose birthday is first in a calendar year (also known as the birthday rule)

The parent whose birthday comes second in a calendar year

You’re under 26 with divorced parents, and both parents cover you under their separate policies.

The parent with custody of the child. If parents have joint custody, the birthday rule applies

The parent who doesn’t have custody, if applicable, or the parent whose birthday comes second in a calendar year

You’re under 26, married, and covered by both your spouse’s and parents' plans.

Spouse’s coverage

Parents’ coverage

You’re married, and you and your partner have insurance coverage through your employers.

Your employer’s coverage

Your spouse’s employer coverage

You're a subscriber on one policy and a dependent on a different one.

The insurance plan on which you are the subscriber

The insurance plan on which you are the dependent

You have a commercial insurance plan and Medicaid.

Your commercial insurance plan.

Your Medicaid insurance plan.

Does Grow Therapy accept secondary insurance?

Yes. However, not all providers - therapists and prescribers - accept secondary insurance. Please contact the support team to ensure your provider accepts your primary and secondary insurance. The team will ensure that both plans are compatible and on file for future billing purposes.

Note: If a provider does not accept your secondary insurance and you continue to see them, you will be responsible for any patient responsibility left after your primary insurance policy processes your claims.

If I'm having COB issues, how can I resolve them?

If Grow Therapy receives notice of an issue with your coordination of benefits, the Billing Support team will ask you to contact your insurance company directly and provide step-by-step guidance. After you've clarified your coordination of benefits information with the insurance company, the Billing Support team will ask you to notify them of the outcome via email. The step-by-step guidance is available here.

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