In coordination of benefits, what does COB refer to in the context of Aflac and Medicare?

• A. Coordination of benefits (COB) governs how multiple sources of benefits coordinate, with Aflac paying additional benefits on top of Medicare as allowed by policy and COB rules
• B. COB refers to the cost of benefits between insurer and employer
• C. COB means benefits are paid in cash only
• D. COB requires the client to forgo Medicare

Answer: (A)

Coordination of benefits describes how more than one payer work together to pay a claim and avoid paying the same costs twice. In the Medicare plus Aflac scenario, Medicare generally pays first for covered services. The Aflac policy can then provide additional benefits to cover gaps—such as deductibles, coinsurance, or services Medicare doesn’t cover—so long as the policy terms and the COB rules allow it. The phrase “on top of Medicare as allowed by policy and COB rules” captures that secondary payment role: Medicare pays what it’s responsible for, and Aflac may pay extra to help with remaining eligible costs, within the limits of the policy.

This doesn’t mean you forgo Medicare, nor does it imply benefits are always paid in cash only. It also isn’t about the financial relationship between an insurer and an employer. The essence is that COB governs the order and amount of payment when multiple plans exist, and Aflac’s supplementary benefits can be paid after Medicare, subject to what the policy permits and the coordination rules.