Patients are assured that their own doctor is overseeing their individual care program. My entire family is covered by the HMSA medical plan I have through my employer. We are also covered by my wife's HMSA medical plan through her employer. For example, if the primary plan covers 80 percent of the eligible charge for a certain service a member receives, the secondary plan will usually cover the remaining 20 percent of the eligible charge. Dual membership can be especially helpful in the event of a hospital stay or serious illness.
Members can save thousands of dollars.
Coordination of benefits refers to the process of applying benefits from two insurance plans to a claim for services. In dual membership and dual coverage situations, we establish which plan pays first. The plan that pays first is called the primary plan. Once this has been determined, we know that the other plan pays second, or is the secondary plan. After benefits from the primary plan have been applied, the secondary plan will often coordinate to pay additional benefits toward the claim.