Reviewed by a licensed dentistTopic: Patient portionQuestion: Two plans
I have two dental plans. How do they work together?
The short answer
Two plans don't mean double the money. One plan pays first (the primary), and the other may pick up some of the rest (the secondary). Together they can't pay more than the full fee. Each plan has its own rules, limits, and covered services, so either one might pay less than you expect, or nothing at all.
More detail
Which plan pays first
- Your own plan, from your job, pays before a plan where you're listed as a spouse or dependent.
- A plan from a current job pays before a COBRA or retiree plan.
- For children covered by both parents, the parent whose birthday comes earlier in the year usually has the primary plan. A custody order can change this.
Why the second plan might pay little or nothing
Some plans use a rule called nonduplication. If the first plan already paid as much as the second plan would have, the second plan pays nothing. Ask the second plan whether it uses this rule.
Tips
- Give the office both insurance cards and tell them which you think is primary.
- Wait until both plans have processed the claim before paying your balance.
- Plans don't all coordinate the same way, so ask each plan how it handles a second plan.
Questions to ask
- Which plan did you bill first?
- Has the second plan processed this claim yet?