A person having a dental plan is not
something to be surprised about nor is it something that should be considered
uncommon. Now what if a person were to have two dental plans? Is this something
that is even possible? The answer to that question is a resounding “yes.”
Whenever a person has two dental plans to his/her name, it is called a “dual
coverage.” While it does not exactly double your coverage, it can, however,
lower down your out-of-pocket fees.
Having dual coverage will work in the same
way even if you are covered by just one dental plan. Having different providers
for each of your dental plans will not affect how your coverage works. The two
insurance companies will simply work with one another to give you the service
that you deserve.
Which
One Pays First?
There are set rules that help determine
which of the plans will pay first and which one will pay afterwards. The main
rule is that the plan that takes you in as an enrolee will serve as the
“primary” plan and the one which marks you as a dependent will serve as the
“secondary” plan.
In the case of dental plans for kids, the
primary company is determined by a method called the “birthday rule.” This is
determined by the birthdate (month and day) of the parent that comes first in
the year. So if the mother’s birthday comes before the father’s birthday that
will be considered the primary account. Court rulings such as divorce
agreements or annulments, however, will supersede the birthday rule.
Check out this information about government dental plans.
How
Does Dual Coverage Work?
If both of your dental plans provide you
with at least two cleanings every year and each giving you at least 80% in
coverage, then this is how it will look like.
·
You will not be able to take
advantage of getting four cleanings per year.
·
Your primary plan will continue
to pay off its benefits and act as if it is the only insurance provider that
you have.
·
Your secondary plan will serve
as a supplement to your primary plan. What this means is that its payments will
be restricted only to either the out-of-pocket costs of the customer under
his/her primary plan or the lesser of its standard benefits.
Special
Clause
Having dual coverage also comes with a
special clause called the “non-duplication of benefits clause.” With this
clause, the secondary plan will not be entitled to pay off any benefits if the
primary one has already paid a similar or higher amount than what the secondary
plan allows for the participating dentist.
For instance, let’s say that both your
primary and secondary plans pay at an 80% level for a particular dental
service. Now if your primary plan allows $100 and your secondary one only
allows up to $80 for a similar treatment, then the secondary account will no
longer have to pay any additional expenses.
Having dual coverage can really help you and people within your group as you will be sharing the total cost of the many benefits being offered by two different dental plan carriers. If you're looking for dental plans visit Eleven Benefits
Or to learn more about health plans check out this video:
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