Secondary orthodontic insurance

The plans set forth rules to determine which plan pays first, (primary) and which plan pays afterwards ( secondary ). The general rule is that the plan that covers you as an enrollee is the primary plan and the plan which covers you as a dependent is the secondary plan. Supplemental dental insurance is a separate plan that enhances your current dental coverage. An individual or family that needs coverage for a particular procedure not covered by their dental plan may choose to purchase supplemental dental insurance to help manage costs.

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The extra plans work best for groups meeting these conditions. Multiple people (adults and children) with crooked teeth. Treatment begins within a short time window for all. Your secondary health insurance can be another medical plan , such as through your spouse. More often, it’s a different type of plan you’ve purchased to extend your coverage.

In that case, you may hear it referred to as voluntary or supplemental coverage. All auxiliary dental insurance plans do not work the same way.

Secondary versus Supplemental Dental Insurance. Each variety offers unique features that affect how much the patient must pay in premiums and receive back in claim payments when they own two policies. The primary plan is the one that pays claims first, as if there were no other insurance. The secondary plan pays claims second and takes into consideration what the primary plan has already paid. The purpose of establishing an order of benefits is to avoid processing delays and prevent overpayment.

CarePlus Supplemental is a dental plan offered exclusively to patients of Dental Associates that are currently covered by a fee for service (FFS) dental plan. There are times when we all need extra dental coverage. The kids (or you) may need braces, or your dentist may tell you that you require treatment that will exceed your dental insurance plan’s annual coverage limit. As noted above, dental insurance typically provides only $500-$0in coverage a year.

Protect the best years ahead. Get advice from our licensed insurance agents at no cost or obligation to enroll. Buying secondary dental insurance as an individual is a common strategy. However, a supplemental plan will usually be more affordable and offer better value to patients shopping privately for additional help.

It is difficult to match network providers with backup individual coverage. This means that the secondary plan will not pay any benefits if the primary plan paid the same or more than what the secondary plan allows for that dentist.

For example, if both the primary and secondary carrier pay for the service at but the primary allows $1and the secondary carrier normally allows $for the same treatment, the secondary carrier would not make any additional payment. Insurance obtained elsewhere, such as through a retiree plan or your spouse's plan, is considered your secondary insurance. Humana Employers Health Plan of Georgia, Inc.

If you have dental coverage through two jobs, the insurer you have been with the longest is your primary carrier. Children with dual coverage fall under the birthday rule. Non-Duplication of Benefits Rule.

Some dental plans have a “non-duplication of benefits” clause which applies when you have more than one dental insurance plan. This means your secondary health plan will not pay any benefits if the primary plan paid the same amount or more than what the secondary plan allows for the same procedure and dentist. Dental insurance plans may cover orthodontics for adults, but if the treatment is desired for purely cosmetic reasons it is usually not covered. Alternatives to braces. One alternative to metal braces is Invisalign.

This option tends to be slightly more expensive than traditional braces, but some dental insurance policies will cover a portion of the cost. Sample of coordination of benefits. You may be covered by two dental plans if you have two jobs that both provide dental benefits or if you are covered by your spouse’s dental plan in addition to your own.

Delta Dental of West Virginia, Inc.