Thursday, November 12, 2009

On dental plans how does it work with two plans and do they cancel each other out?

Nope.


Your primary plan covers first.


Your secondary plan covers second.


Sometimes you don't pay anything.


Sweet.

On dental plans how does it work with two plans and do they cancel each other out?
Neither plan cancels each other out. There should be a "Coordination of Benefits" (COB) explanation available from one of your insurers.





One plan will be designated as the "primary" plan and will pay first. They will pay what they said they cover. Let's say Orthodontia - typically that's about a 60/40 split with a $5000 cap on most plans I've seen. In this case, the primary would pay 60% of the bill up to 5K, then, if you identified the secondary plan, they'd automatically bill the second plan for the balance.





COB is regulated in most states, and does work differently according to who is the primary holder of the insurance plans and if Medicare/Medicaid is involved. Your best bet is to check with your insurer, then, your state.
Reply:Without more details, it's impossible to answer accurately. I can, however, give you some basics of dual insurance.





If a married couple each carries dental insurance and both elect to cover their spouse, it works like this: The individual's own plan is primary. The individual's spouse's plan is secondary and payment under that plan is conditional on a clause called "coordination of benefits."





Sound confusing? Believe me, it is!!! Secondary insurance might cover all, most, or nothing of what the primary doesn't pick up. The only way to know is to ask the secondary insurance how they "coordinate benefits".





Don't ask your dental office, ask the secondary company. There are more plans and exceptions than there are pictures of Brad and Angelina, so no one can be an expert on them all.





Good luck!


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