What if I have other health benefits?
When you or your enrolled family members have coverage under both a Costco healthcare plan and a Non-Costco Health Plan, the plans will pay benefits according to Coordination of Benefit (COB) provisions described in the Summary Plan Description. COB rules determine which plan is primary and which is secondary. In general:
- The primary plan pays first without regard to the possibility that another plan may cover someexpenses.
- A secondary plan pays after the primary plan and may reduce the benefits it pays so that payments from all plans do not exceed 100% of the total allowable expense.
For purposes of COB, medical and dental coverage are considered separate plans. Therefore, Costco medical benefits will be coordinated with other medical plans and Costco dental benefits will be coordinated with other dental plans.
COB does not apply to the Prescription Drug Program or to the HMSA healthcare plans for Employees in Hawaii. Also, if you or family members are covered by an HMO or similar prepaid health or vision plan in addition to a Costco medical plan, your Costco plans will not coordinate with that HMO or pay benefits for any charges for services or supplies furnished by that HMO.
Notifying Costco of other plan coverage
It’s your responsibility to notify Costco if you or your family members have coverage under any Non-Costco Health Plan. Failure to provide this notification may result in a loss of your Costco plan benefits. In addition, you will be required to fully reimburse the Program for any claims paid in excess of the amount that should have been paid under the Program including the COB provision.
With that, we need to be aware of any health insurance coverage you may have other than your Aetna plan through Costco. For example, are you also covered under your spouse’s plan, Medicare, etc? Without this information, claim payments may be delayed.
You can notify us of changes or updates online or by phone. Here’s how:
By Phone
You can also call Member Services at 1-800-814-3543 between the hours of 8:00 a.m. to 6:00 p.m. Central Standard Time (CST).
Online
Fill out the Coordination of Benefits Contact Form below and click Submit when completed.