Can You Have Two Dental Insurances ?
Navigating the world of insurance can often feel like a maze, especially when it comes to dental plans. If you’ve ever wondered, “Can I have two dental insurances?” or “How could this benefit me?” you’re not alone. The idea of having two dental insurance policies may sound complicated, but it can be a strategy that offers you significant savings, extra coverage, and peace of mind.
In this guide, we’ll break down everything you need to know about dual dental insurance. From understanding how it works, to exploring its benefits and drawbacks, you’ll gain a clearer perspective on whether this strategy could work for you. Let’s explore the options you have and how to make the most of them.
What is Dual Dental Insurance?
Having dual dental insurance, or secondary dental insurance, means you’re covered by two dental insurance plans. While you may primarily rely on one insurance, the secondary insurance can help cover remaining costs that the first one doesn’t fully pay for, such as co-pays, deductibles, or certain treatments.
Types of Dental Insurance
There are different types of dental insurance plans, and the way dual coverage works can vary depending on the kind you have. Here’s a quick overview of the two most common types of plans you might encounter:
- PPO (Preferred Provider Organization): PPO plans allow you to choose any dentist, but you get better rates if you use dentists within the plan’s network. They offer flexibility but may come with higher premiums.
- HMO (Health Maintenance Organization): HMO plans typically require you to use a network of dentists, and they often have lower premiums. However, the network restrictions are tighter than PPOs.
While PPOs are the most common when it comes to dual coverage, it is possible to have a combination of HMO and PPO plans, though the coordination between them may be more complicated.
When Would You Have Two Dental Insurances?
You might end up with dual dental insurance in various situations. Common scenarios include:
- Employer + Spouse’s Plan: If both you and your spouse have dental insurance through your respective employers, you may be eligible to have coverage from both plans.
- Employer + Medicaid: For those who qualify for Medicaid and have an employer-provided dental plan, Medicaid can often act as a secondary insurance to cover costs that your primary plan doesn’t.
Can You Legally Have Two Dental Insurances?
Yes, it is absolutely legal to have two dental insurance policies, and it happens more often than you might think. However, there are rules for how your plans coordinate with one another, which is known as the Coordination of Benefits (COB). These rules ensure that your insurance providers don’t pay more than the total cost of your dental care.
Coordination of Benefits (COB)
COB rules are put in place to prevent overpayment and ensure the correct order of claims. Typically, one insurance is considered the primary insurance, while the other is secondary. The primary insurance pays first, and the secondary insurance covers whatever remains, up to the limits of its coverage.
For example, if your primary insurance covers 70% of your dental treatment costs, your secondary insurance might cover the remaining 30%. However, your secondary plan won’t always pay 100% of the remaining cost—often, it will cover a percentage or have specific limits in place.
How Does Dual Dental Insurance Work?
Now that you know it’s possible and legal to have two dental insurance plans, the next logical question is, How does it actually work?
Primary vs. Secondary Insurance
When you have two dental plans, one will be considered the primary insurance and the other the secondary insurance. Here’s how it works:
- Primary Insurance: This plan will pay first, according to the benefits it offers. For example, if your plan covers 80% of the cost of a dental procedure, they’ll pay 80% first.
- Secondary Insurance: This plan covers the remaining balance after the primary insurance has paid. Depending on the terms of your secondary insurance, it may cover the full remaining amount or just a portion of it.
Filing a Claim with Dual Insurance
When you visit the dentist, you’ll usually provide both your primary and secondary insurance information. Your dentist will first submit the claim to your primary insurance provider, who will pay their share. Once that’s settled, the remaining balance will be forwarded to your secondary insurance for payment.
It’s important to inform both your dentist and insurance providers that you have dual coverage to avoid any confusion during the claims process.
Out-of-Pocket Costs
With dual dental coverage, your out-of-pocket expenses—like co-pays, deductibles, and coinsurance—could be significantly reduced. However, you’ll want to keep track of your claims to ensure everything is properly coordinated between the two plans.
Pros and Cons of Having Two Dental Insurances
As with any insurance strategy, there are both pros and cons to having two dental plans. Grasping these concepts can assist you in making a well-informed choice.
Pros of Dual Dental Insurance
- Reduced Out-of-Pocket Costs
The most significant advantage is the potential for lower out-of-pocket expenses. Dual coverage means that your secondary insurance can cover costs that your primary insurance doesn’t, such as co-pays or deductibles. - Increased Coverage
You can receive more extensive coverage, especially if you require expensive dental treatments like crowns, root canals, or orthodontics. With dual insurance, you might be able to get more treatments covered at a lower overall cost. - More Provider Choices
If one of your plans has a limited network, your secondary insurance might provide access to additional providers, giving you more flexibility in choosing dentists.
Cons of Dual Dental Insurance
- Higher Premiums
The most obvious disadvantage is that having two dental insurance plans means paying premiums for both. While your secondary insurance might reduce costs, it’s essential to weigh whether the savings outweigh the added premiums. - Complex Claims Process
Filing claims can get complicated with two insurers. There’s a risk of miscommunication between providers or claims being rejected if they’re not coordinated correctly. - Coverage Limitations
Both plans may have coverage limits, and you might not receive full reimbursement for all dental expenses. For example, the secondary insurance might only cover a portion of the remaining balance, leaving you with some costs.
How to Maximize the Benefits of Dual Dental Insurance
If you’re considering dual dental coverage, there are steps you can take to maximize its benefits and ensure you’re getting the most out of both plans.
1. Understand Your Benefits
Start by reviewing the details of both your primary and secondary insurance plans. Understand what each plan covers, including co-pays, coverage limits, and exclusions. This will help you anticipate how much you’ll pay out-of-pocket and how the two plans will work together.
2. Communicate with Your Dentist
Make sure your dentist is aware that you have two insurance plans. This will help them bill both insurers correctly and avoid mistakes. Some dental offices may be unfamiliar with coordinating benefits between two plans, so it’s important to stay on top of the process.
3. Keep Track of Claims
Monitoring your claims can ensure you’re receiving the maximum benefits possible. If you notice any discrepancies or if a claim hasn’t been processed correctly, contact both insurance providers immediately to resolve the issue.
Real-World Examples of Dual Dental Insurance Scenarios
Let’s look at a couple of real-life examples to illustrate how dual dental insurance works in practice:
Example 1: Employer Insurance + Spouse’s Plan
Imagine you have a dental PPO plan through your employer, but your spouse also has a dental PPO plan through their employer. Both plans cover similar treatments but have different co-pays and deductibles. By using both plans, you can reduce the amount you pay for expensive procedures. For instance, if your primary insurance covers 60% of a $1,000 dental procedure, the secondary insurance might cover the remaining 40%.
Example 2: Employer Insurance + Medicaid
For individuals eligible for Medicaid, this government-provided program often acts as secondary dental insurance. If you have employer-provided dental insurance as primary, Medicaid can cover the remaining costs. For example, if your primary insurance covers 80% of a treatment, Medicaid may pick up the remaining 20%, reducing your out-of-pocket costs.
Key Considerations Before Choosing Dual Coverage
Before you decide to take the plunge into dual dental insurance, here are a few things to consider:
- Cost: Will the benefits of having two dental plans outweigh the extra premium costs?
- Dental Care Needs: If you only need basic dental care, dual insurance might not be necessary. However, if you need major dental work, the added coverage could be valuable.
- Provider Network: Ensure that both plans offer a network of dentists that you are comfortable with, and that there’s no overlap or gaps in coverage.
Frequently Asked Questions (FAQ)
1. Can You Have Two Dental Insurances?
Yes, having two dental insurances is legal, and it’s quite common in many households. The key is ensuring both insurance plans coordinate correctly to maximize your coverage.
2. How Does Dual Dental Insurance Work?
The primary insurance pays first, and the secondary insurance covers the remaining balance. However, the secondary insurance won’t always pay 100% of the remaining amount—it depends on the terms of the plan.
3. Is Dual Dental Insurance Worth It?
For individuals who need extensive dental care, dual insurance can help significantly reduce out-of-pocket costs. However, it may not be worth the added premiums for those with minimal dental needs.
4. Do Both Insurances Need to Be PPO Plans?
Not necessarily. While PPO plans are common for dual coverage, you can have one PPO plan and one HMO plan. However, coordinating benefits between the two may be more complicated.
5. Can I Have Two Dental Insurances Through My Employer?
Yes, it’s possible to have dental insurance through both your employer and your spouse’s employer, as long as both plans allow dual coverage.
Conclusion
Dual dental insurance can be a valuable tool in reducing your dental care costs and providing you with better coverage for expensive procedures. By understanding how it works, evaluating the pros and cons, and following a few key steps, you can make the most of having two dental insurance plans. Be sure to review your options carefully, and speak with a dental insurance expert if you need help coordinating your coverage.
Ready to explore your dental insurance options? Speak with a licensed insurance expert today to see if dual coverage could work for you!
