Can You Have Two Dental Insurances And Use Them Both?

Two Dental Insurances is a valuable tool in managing the costs of dental care, but sometimes one policy isn’t enough. It’s not uncommon for individuals to have access to multiple dental insurance plans, particularly if they’re covered by their employer’s plan and also have a plan through their spouse or another family member. This raises a common question: Can you have two dental insurances, and if so, can you use both? The answer is yes, but there are specific rules and coordination of benefits that come into play. Here’s everything you need to know about having two dental insurances and how you can make the most out of both.

How Does Dual Dental Insurance Work?

When you have two dental insurance policies, it’s known as having “dual coverage.” While you are legally allowed to have multiple insurance policies, how the benefits are applied depends on a process called coordination of benefits (COB). COB ensures that your insurance providers work together to determine who pays first (primary insurance) and who pays second (secondary insurance).

Here’s a breakdown of how dual dental insurance works:

• Primary Insurance: The primary insurance is the one that covers you first. If you are covered by both your own policy and a policy through your spouse, your policy would generally be considered primary if you’re the policyholder.
• Secondary Insurance: The secondary insurance steps in after the primary insurance has paid its share. It helps cover any remaining costs like deductibles, co-pays, or uncovered services.

You don’t have to file claims with both insurers. Your dental provider typically submits the claim to your primary insurer first. After they process the claim, the dental office will submit the remaining balance to your secondary insurer.

Advantages of Having Two Dental Insurances

1. Lower Out-of-Pocket Costs: Dual coverage can significantly reduce the amount you pay out-of-pocket. For example, if your primary insurance covers 80% of the cost for a dental procedure and your secondary insurance covers an additional 10%, you may only be responsible for the remaining 10%.
2. Access to More Providers: Having two insurance plans can sometimes expand your network of preferred providers, giving you more options for care.
3. Increased Coverage: Depending on the policies, dual coverage may provide additional benefits for things like orthodontics, teeth cleanings, or more expensive treatments like crowns and root canals.
4. Maximizing Benefits: In some cases, you may be able to maximize the benefits offered by both plans, allowing you to get more services covered or to cover treatments that one insurance policy wouldn’t fully cover on its own.

How to Coordinate Benefits with Two Dental Insurances

It’s important to understand how the two policies will interact and the rules that each insurance company follows. Each insurance company has its own coordination of benefits guidelines. Here’s an overview of how they typically work:

1. Birthday Rule: This rule is often used when children are covered by both parents’ insurance. The insurance policy of the parent whose birthday falls earlier in the year is considered the primary insurance. This rule is generally used when determining primary vs. secondary coverage for dependent children.
2. Insurance Plan Priority: If both plans are through employer-provided coverage, the plan you’ve been enrolled in the longest may be considered primary.
3. Secondary Coverage: The secondary insurance may only cover what the primary insurance didn’t cover, meaning there may still be out-of-pocket expenses if both insurances don’t cover the full cost of the dental procedure.
4. Out-of-Network Costs: If one of your dental insurances is out-of-network, it may not pay for services rendered, or it may cover a smaller portion of the cost. In this case, the benefits from your primary insurance would still apply, but secondary coverage may not be as helpful if it’s tied to an in-network provider.

Are There Any Limitations?

While dual dental insurance can be beneficial, there are limitations:

• Not Everything Is Covered: Even with dual coverage, some services may still require you to pay for them entirely out-of-pocket, especially if both insurers limit what they will pay for specific procedures.
• Coordination of Benefits Isn’t Always Perfect: Some procedures may be processed incorrectly, or you might find that your out-of-pocket costs are still higher than expected. This can be frustrating but is often a result of how your dental office submits the claims to the insurers.
• Different Coverage Levels: If the two plans have different coverage levels or limits, you may still find that the combined insurance coverage doesn’t completely eliminate your out-of-pocket costs.

When Should You Avoid Dual Dental Insurance?

While it may seem like a great idea to have two dental insurances, it’s not always necessary or the most cost-effective. If both plans offer similar coverage or if you’re unlikely to reach the deductible on both policies, it may not be worth the hassle of managing two insurance plans. Additionally, having dual coverage can increase your premiums and administrative work without offering substantial benefits.

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Frequently Asked Questions (FAQs)

1. Can I use two dental insurance policies for the same treatment? Yes, you can use both insurance policies for the same treatment as long as they follow the coordination of benefits guidelines.
2. Do I need to notify my dentist about having two dental insurances? Yes, inform your dentist’s office so they can properly file claims with both insurance companies and help you maximize your coverage.
3. What happens if one insurance plan doesn’t cover certain procedures? If your primary insurance doesn’t cover a procedure, you can submit the remaining balance to your secondary insurance, if it covers it.
4. Can I switch the order of primary and secondary insurances? Generally, the order is determined by each insurance company’s guidelines, such as the birthday rule or employment status. You cannot arbitrarily switch the order.
5. Does having dual coverage mean I won’t have any out-of-pocket costs? Not necessarily. Even with two insurance policies, you may still have some out-of-pocket expenses, depending on the specifics of the plans and procedures.

Conclusion

Having two dental insurances can be a strategic way to minimize your out-of-pocket costs and maximize your coverage. However, it’s important to understand how dual coverage works, the coordination of benefits, and any limitations that may apply. By carefully reviewing your insurance plans and consulting with your dentist, you can make the most of your coverage and reduce your overall dental care costs.