Can payment of medical benefits be coordinated between an individual medical insurance plan and a group medical insurance plan covering the same person?

Answer 1

Its possible but unlikely. If one policy is direct pay then both should pay as prime and essentially ignore one another.

Clarification:

It would be considered insurance fraud to not notify each insurance company of your coverage with the other. Otherwise, you would actually be making a profit from both insurers paying the full amount they would pay if you only had coverage with one company, which is illegal and would result in serious consequences.

When a person is covered under two medical insurance policies, one is considered the primary insurer, while the other is considered the secondary insurer. Typically, the primary insurance policy will pay their percentage, then the secondary will pay the balance. But you still have to meet your deductibles for both insurers, as well as paying your co-pay amount.

You need to contact both insurance companies to determine which one is your primary coverage, which will be determined by several factors, depending on your status, such as married, dependent, etc.