If both Health Tradition and another health plan cover you or your family, these
plans will coordinate benefits and share the responsibility for paying your eligible
medical bills. You may not, however, be reimbursed for more than the cost of any
healthcare service you receive. Coverage with more than one health plan most often
occurs when two spouses work for different employers and each enrolls the other
and/or children in their health plan. When this occurs, one health insurance plan
becomes primary and one becomes secondary.
For members who are Medicare eligible, please
contact the Plan directly for more detailed information on filing order.
Additional references are listed below.
If Health Tradition is primary, you will need to file your Explanation of Benefits
(EOB) forms with your secondary insurance plan. An EOB is a form sent to you after
a claim has been processed outlining how much money the plan paid and the amount
you are personally responsible for paying.
If Health Tradition is secondary, you will need to file your primary insurance plan's
EOB forms or Medicare Summary of Notice with Health Tradition. It is your responsibility
to provide us with complete information about your other health insurance plan(s).
If we do not have complete information, we cannot process your claims correctly.
Your EOB will report a denial of payment for lack of information when the other
health insurance plan information is not sent along with your claim.
Coordination of Benefits for Prescriptions
Coordination of benefits does not apply to Premier or Premier Plus members who have
other commercial coverage (non-Medicare or Medicaid). Members must choose one of
the coverage plans available to them for prescription coverage.
If you have questions about prescriptions or this process, please contact Customer
Service toll-free at 1-877-832-1823.