Other Information

If You Are Covered by Two Plans

The Yale New Haven Health medical and dental plans have coordination-of-benefits (COB) provisions that help prevent duplication and overpayment of benefits when you or covered members of your family are covered by more than one plan. Here’s how it works:

• If you, the employee, are the patient, our plan pays benefits first. The other plan then may pay benefits according to its coordination-of-benefits rules after you submit the claim.
• If your spouse is the patient, his or her plan will pay benefits first. Our plan will pay its normal benefits, minus any benefits paid by your spouse’s plan. This means your spouse won’t receive any benefits from our plan if his/her plan pays benefits that are equal to or greater than the benefits our plan would otherwise pay.
• If your child is the patient and he or she is covered by our plan and your spouse’s plan, the plan that will pay benefits first is determined by when your or your spouse’s birthday occurs. The plan of the person whose birthday occurs earlier in the year will pay benefits first. If our plan pays benefits second, its normal benefit will be reduced by the amount paid by the other plan.