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How To File A Claim When You Have More Than One Health Insurance Coverage

When One or Both Plans Is A PPO

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A PPO will determine what it will pay based on whether you are treated in or out of network. If you are treated by a doctor who is part of the PPO network, and you only pay a co-pay, the other carrier will only reimburse the co-pay and follow the steps for when one or both plans require a co-pay.

If, however, you use a doctor that is out of the PPO's network, or if using a network provider reduces your co-insurance percentage, then you should obtain a claim form and file a claim as instructed above under when both plans require filing a claims form.


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