Should You Use Your Spouse’s Plan First? Understanding Coordination of Benefits

Intro: Why You Could Be Missing Out on 100% Coverage

If you and your spouse both have extended health insurance — congratulations. You’re one of the lucky Canadians with double the protection.

But here’s the catch:

If you don’t coordinate your claims properly, you could be leaving money behind — or worse, having claims denied.

In this article, you’ll learn:

• What Coordination of Benefits (COB) actually means
• Whether to use your own or your spouse’s plan first
• How to claim from both plans — legally and efficiently

💡 What Is Coordination of Benefits?

Coordination of Benefits (COB) is a system used by insurance companies when a person is covered by more than one plan.

It lets both plans work together — without “double-dipping” — to maximize your reimbursement.

Example:

Your massage costs $100

• Plan A pays 80% = $80
• Plan B pays the remaining 20% = $20
• ✅ You pay $0 out of pocket

That’s what COB is all about.

🔄 Whose Plan Do You Use First? The Golden Rule

Person Receiving Care	Submit to…
You (employee)	Your own plan first
Your spouse	Their own plan first
Your child	Parent whose birthday comes first in the calendar year

✅ Never submit the same claim to both plans at the same time.
❌ That could be flagged as duplicate billing (and even fraud).

✅ How to Submit a Claim to Two Plans (Step-by-Step)

1. Submit to your own insurer first
   • Get the Explanation of Benefits (EOB) or claim statement
     
2. Submit the unpaid balance to your spouse’s plan
   • Attach the EOB + original receipt
     
3. Keep copies of everything
   • CRA may request documentation later

💬 Tip: Ask Ruby at insurance.rmtclinic.net to help organize your COB process.

⚠️ Common Mistakes That Delay Reimbursement

• ❌ Submitting both claims at once (confuses the system)
• ❌ Forgetting to include the EOB in second submission
• ❌ Using the wrong plan as primary
• ❌ Listing the wrong family member as the patient

➡️ These errors delay or void your claims, and could cost you hundreds per year.

🔐 Pro Tip: Register Your COB Info With Both Insurers Now

You don’t need to wait for a claim to set this up.

✅ Go to each insurer’s portal
✅ Add your spouse and dependents to your profile
✅ Provide policy numbers, birthdates, and relationship
✅ Enable Coordination of Benefits

📍 Major providers that support COB:

• Sun Life
• Manulife
• Canada Life
• Desjardins
• Greenshield
• Medavie Blue Cross
• GroupHEALTH
• Equitable Life

💬 Ruby Can Handle the Paperwork (Almost)

Use RMTClinic.net to book with clinics that support direct billing for both plans. Even better, use insurance.rmtclinic.net to ask Ruby, your AI guide, to walk you through claim steps and reminders.

📣 Don’t Leave Your Second Plan Untapped

Thousands of Canadians only use one plan — and leave 20%–30% of their coverage unused every year.

Coordination of Benefits isn’t just paperwork. It’s how smart families maximize their health benefits.

✅ Search for COB-friendly clinics near you → RMTClinic.net
✅ Ask Ruby to help you submit → insurance.rmtclinic.net
✅ Use both plans properly this year → RMTClinic.net/insurance