If you have another health plan or insurance coverage that provides benefits that are the same or similar to your HMSA plan, HMSA will coordinate your HMSA benefits with your other coverage.
Other coverage includes:
- Group health plan or insurance.
- Other group benefit plans.
- Non-group health plan or insurance.
- Medicare or other governmental benefits.
- The medical benefits coverage in your automobile insurance (whether issued on a fault or no-fault basis).
When you have coverage under two group health plans (also known as dual coverage), one plan is primary and the other plan is secondary. In general, the primary plan pays first and the secondary plan pays the portion not paid by the primary plan. Primary plan payments plus secondary plan payments won’t exceed the eligible charge for the covered service provided. See your Guide to Benefits for more important information on coordination of benefits.
To enable HMSA to coordinate your benefits, you must:
- Give information to your health care provider about the other coverage at the time services are rendered, and
- Complete the Coordination of Benefits Subscriber Questionnaire.
Note: Refer to your Guide to Benefits for more information on coordinating benefits with automobile insurance (fault or no-fault) and workers’ compensation insurance. Third-party liability coverage is subject to guidelines stated in your Guide to Benefits.