Skip to main content

Coordination of Benefits

Are you and your spouse covered by separate benefit plans? Then you may be able to enjoy reimbursement for up to 100% of eligible claims through Coordination of Benefits.

How Coordination of Benefits works
Common questions
Drug request changes (July 1, 2026)

Starting July 1, 2026, a new Coordination of Benefits (COB) process will apply to all plans.
Visit our FAQs to learn what this means for your drug requests.

How does it work?

Common questions

If you and your spouse have separate benefit plans, you may be able to use both plans to get up to 100% reimbursement on eligible claims depending on your plans and their limits.

Submit your claim to us first, then provide a copy of the processed claim to your spouse’s insurer.

Have them submit the claim to their insurer first, then provide a copy to us.

First, submit to the insurer of the partner whose birthday comes earlier in the calendar year. Then provide a copy to the other partner’s insurer.

Special Authorization drug request (new changes starting July 1st, 2026)
These FAQs explain the new process if you have more than one drug plan.

This change affects how we review drug requests when you have more than one drug plan.
Your main insurer must review your request first. After that, Medavie Blue Cross can review it as your second plan.

This change is happening to ensure:

  • Claims are processed in the right order
  • Each insurer pays their share appropriately
  • Drug coverage decisions are consistent and accurate
  • Better management of overall drug costs

You can send your SAU request to both insurers at the same time. If Medavie Blue Cross is your second plan, your request will be put on hold until we get a decision letter from your main insurer.

Your request will be temporarily declined until we get the required information.

No. A decline in this case does not mean your drug is not covered. It means we need your main insurer’s decision before we review your request again.

There may be a short delay while:

  • Your primary insurer reviews your request, and
  • You send their decision to Medavie Blue Cross

You can submit your documents in a few different ways:

A decision letter is a document from your primary insurer that shows whether your drug was approved or declined.
A decision letter needs to show the patient’s name and the drug name. We need this before we can review your request as a secondary plan.

This change will take effect on July 1, 2026.

If you no longer have another drug plan, update your information with Medavie Blue Cross as soon as possible. Call 1-800-667-4511.

Once updated, we can review your request as your main insurer without needing a decision from another plan.