Coordination of Benefits

Is the claim for you?

Submit your claim to us first, then provide a copy of the processed claim to your spouse’s insurer.

EXAMPLE

John has a Medavie Blue Cross plan through his employer, while his wife Beth’s employer-sponsored plan is with another insurer. John claims $100 from Medavie Blue Cross for a dental checkup. He receives an 80% reimbursement (for $80). Along with his reimbursement, he receives an Explanation of Benefits (EOB) explaining the eligible claim portion paid. He sends his EOB statement, along with a copy of the original claim, to Beth’s plan.

Beth receives a cheque for the eligible amount of the unpaid balance from her plan. John receives up to 100% reimbursement for the cost of his checkup.

Is the claim for your spouse?

Have them submit the claim to their insurer first, then provide a copy to us.

EXAMPLE

Beth claims $200 from her employer-sponsored plan for eyeglasses. She receives an 80% reimbursement ($160). Along with her reimbursement, she receives an EOB explaining the eligible claim portion paid. She sends her EOB statement, along with a copy of the original claim, to Medavie Blue Cross.

John receives a cheque for the eligible amount of the unpaid balance from Medavie Blue Cross. Beth receives up to 100% reimbursement for the cost of her glasses.

Is the claim for your kids?

First, submit to the insurer of the partner whose birthday comes earlier in the calendar year. Then provide a copy to the other partner’s insurer.

EXAMPLE

John and Beth’s daughter claims pharmacy prescriptions. Beth's birthday is in May and John’s is in July— so the claim is sent to Beth’s plan first, and later to Medavie Blue Cross for reimbursement of the remaining balance.