When was the last time you remember dental insurance plans receiving a makeover? The Affordable Care Act (ACA) considers dental coverage essential for children, but not adults. Since the general dental coverage model hasn’t been updated since the 1970s, you may find yourself needing additional dental coverage.
The average dental plan offers maximum annual limits of $500 to $1,500, often times maxing out one’s benefits after a root canal or a couple of standard fillings. As a result of these outdated dental plans, many people will often go without much-needed dental care.
What Is Dual Coverage?
Perhaps the best solution to this dilemma is called dual coverage. While it is possible and beneficial to carry a primary and secondary dental plan, there are certain restrictions to be aware of. With dual coverage, the two insurers will work together, forming what is known as a “coordination of benefits” and will work together to determine which policy will pay for what. In the event that you have employer-sponsored coverage, this will be considered the primary plan, while any other plans, regardless if it was purchased privately, through a spouse’s employer, or through a retirement plan, would be considered your secondary plan. The primary plan may also be the plan you’ve held for the longest time.
How Does Dual Coverage Work?
When it comes to your annual cleanings, both policies will not cover you, instead your primary plan would pay for your two allotted cleanings annually, with the secondary policy simply being supplementary to your primary policy. Non-duplication clauses are standard in most policies, meaning that secondary policies only pay in the event that the primary plan does not pay up to the primary plan’s allowed amount. For example, if your primary plan covers 80% of your dental services, and your co-pay is 20%, but for some reason, the primary plan only pays 70%, the secondary policy would then pay the 10% difference, but only after you have paid your portion, or in this case, 20% co-pay amount.
If you have any questions in regards to your current dental policy, or are looking to add coverage, contact Brazelton Insurance Group.