How to Get Coordinating Insurance Benefits

In these days of sky-high medical bills and overly complicated insurance systems, one of many high-pressure points is the web of interlocking and diverse policies on the coordination of benefits. Some plans will allow secondary billing, others say any other plans make theirs invalid. In many cases, companies will not actively inform their policy holders; it falls on members to call in and verify information to safeguard their coverage.

Instructions

1. Ask about the coordination of benefits policies of your existing plan. Some plans will allow the coordination of benefits with another plan, and some won't. Many times, there are complicated limits to what kind of other plans yours will cooperate with. Make sure you get a straight answer from your company. "I don't know" is not acceptable.

2. Try an easy plan switch. Ask the rep: "Are there other plans similar to mine that will coordinate benefits with (x) other plan?" If so, you may be able to make the switch easily and without a lot of new paperwork. Your premiums or other features might change slightly (or a lot!) make sure you are not trading away anything important.

3. If your existing policy has a very low maximum annual cap, or a very high deductible, and your company is not allowing coordination of benefits, tell them that you will drop existing plans and choose a comprehensive one. The loss of a customer may encourage them to work with you on allowing coordination of benefits.

4. Try reasoning with the providers of your plan (through contact staff). Provide them with reasons for your decision, demonstrating that there are some comprehensive plans that give "fuller" coverage, the plans that they administer do not fully cover the member. Get answers from reps on issues that affect the common policy holder. Do not allow them to get off with glib answers and patronizing explanations of bad policy. Sometimes, this seems to be the stock provision of a large insurer, but making them work beyond to a more reasonable discussion of benefits can be in your favor.

5. Shop around and get a more comprehensive plan. As insurance adapts to consumer needs (albeit slowly), some rising companies are offering more decent coverage that will persuade non-covered individuals that buying a policy is in their best interest. Work with one of these new companies to get a policy that works for you.

Tips & Warnings

• If your existing coverage is through an employer, then that employer may have to be a party to any insurance changes. The ability to bargain on the insurance market is sometimes limited to self-purchased plans, which is why many workers are choosing to self-purchase rather than accepting bad plans from their employer. For employer plan holders, having a frank discussion within the office is a first step to change.