Fatima is covered under her own employer's group health plan and her husband's group health plan. According to the Coordination of Benefits (COB) guidelines, how should she submit a claim for her own prescription drugs?

Question: Fatima is covered under her own employer's group health plan and her husband's group health plan. According to the Coordination of Benefits (COB) guidelines, how should she submit a claim for her own prescription drugs?

Answer options: ✅ She first claims from her own plan, then from her husband's plan for the balance.

• She first claims from her husband's plan, then from her own plan for the balance.
• She must choose only one plan to submit the claim to.
• Both plans pay 50% of the total claim regardless of individual limits.

Correct answer: She first claims from her own plan, then from her husband's plan for the balance.

Explanation: The Coordination of Benefits (COB) guidelines ensure that the total amount claimed does not exceed 100% of the actual expenses. The policyholder first claims from their own employer's plan (primary insurer) and then any balance from their spouse's plan (secondary insurer).