When You’re Covered by More Than One Plan
If you are covered under UC SHIP as well as a spouse’s or parent’s health plan, your spouse’s or parent’s plan is the primary carrier and UC SHIP is the secondary carrier — except when you’re also covered by Medi-Cal, MRMIP, or TRICARE. The primary carrier’s benefits are applied to the claim first. The unpaid balance is usually paid by the secondary plan, to the limit of its responsibility.
UC SHIP coordinates your benefits between both health plans to make sure payments do not exceed 100% of charges for the covered services.
If you have other coverage in addition to UC SHIP, please complete the COB questionnaire [PDF] and submit it to Anthem.
Determining the Primary Plan for Payment
To get the most out of your coverage, it helps to know how the two plans work together.
For care at the SHS, UC SHIP is the primary carrier. The SHS will submit claims to Anthem for SHS services. To be reimbursed for any copayment or coinsurance you pay, you must submit a claim for that amount to your other insurance carrier. The SHS does not submit claims to other health plans.
For care outside the SHS, your other medical plan is the primary carrier. That means it must pay claims first, before any remaining charges can be submitted to UC SHIP for payment.
Exceptions: If you are covered by Medi-Cal, MRMIP, or TRICARE in addition to UC SHIP, UC SHIP is the primary health plan, and your other plan is the secondary plan.
If you have questions about coordinating between plans, call Anthem Blue Cross Member Services at (866) 940-8306.