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WHO PAYS FIRST?
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There are a number of rules that set out the order in which claims are to be paid.
This section explains that order, taking into account a variety of different circum-
stances.
If you are covered as a member under a plan, that plan will always pay before a
plan that covers you as a dependent. In other words, you must submit the claim to
your own plan first.
Example:
If you have coverage with your employer plan and as a dependent with your
spouse's employer plan:
• Your employer plan pays your claim first.
• Your spouse's plan pays your claim second.
But if you have the same status under more than one plan, the plan that covered
you the longest pays first.
Example:
If you have two plans because of two part-time jobs:
• Job one – member of plan since March 3, 1995
• Job two – member of plan since February 2, 2001
Therefore - The plan with Job one pays first - it has covered you longer.
