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.
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: