Wondering if you can leverage Delta Dental’s plan alongside another dental insurance plan? The answer is yes! Delta Dental participates in what’s called “dual coverage” or “coordination of benefits” (COB).
This means you can potentially maximize your dental benefits by combining coverage from two sources.
While Delta Dental doesn’t directly control whether you have dual coverage, they work with your other plan to ensure you get the most out of both.
Here’s a breakdown of how dual coverage works and what you need to know as a Delta Dental member.
Does Delta Dental allow dual coverage?
Delta Dental doesn’t decide if you can have dual coverage, but they can help coordinate benefits if you do.
Dual coverage means you have two dental insurance plans to help pay for your treatment. It doesn’t double your benefits, but it can lower your out-of-pocket costs.
Here’s how it works:
- One plan is your primary plan, and the other is your secondary plan. Usually, the primary plan comes from the person insured first.
- Your primary plan pays most of the covered expenses.
- Your secondary plan then helps cover the remaining costs, up to its limits.
Dual coverage simply means you have two dental insurance plans that can be used to pay for your dental procedures. These plans can come from various sources, such as:
- Your employer
- Your spouse’s employer
- An individual plan you purchased yourself
It’s important to understand that dual coverage doesn’t mean your benefits are doubled. Instead, your plans work together to pay a larger portion of your dental expenses.
Benefits of Dual Coverage with Delta Dental
There are several advantages to having dual coverage with Delta Dental:
- Reduced Out-of-Pocket Costs: By combining two plans, you can potentially decrease the amount you have to pay for your dental care. Your primary plan pays first, followed by your secondary plan kicking in to cover remaining costs, up to their limits.
- More Coverage for Procedures: Some procedures might have higher coverage under your secondary plan compared to your primary plan. Dual coverage helps maximize the overall coverage you receive.
- Meeting Deductibles Faster: If you have a deductible (a set amount you pay before your insurance starts covering costs), dual coverage can help you meet it quicker. Once your primary plan covers its deductible amount, your secondary plan can start contributing.
How It Works
Here’s a simplified explanation of the coordination process:
- Identify Your Primary Plan: Typically, the plan that insured you first becomes your primary plan. This could be your employer’s plan or your spouse’s, depending on enrollment dates.
- Primary Plan Pays First: Your primary plan processes your claim and pays according to their coverage schedule. This might involve a percentage of the covered cost or a set dollar amount.
- Secondary Plan Steps In: After your primary plan pays its share, any remaining eligible expenses get sent to your secondary plan (Delta Dental in this case).
- Secondary Coverage Applies: Delta Dental then reviews the claim based on your specific plan details and applies their coverage. They’ll pay up to their benefit limits, reducing your out-of-pocket cost further.
Key Facts About Dual Coverage
Here are some key points to keep in mind when you have dual coverage with Delta Dental:
- Non-Duplication of Benefits Clause: Some dental plans, including some Delta Dental plans, might have a “non-duplication of benefits” clause. This means you won’t receive more than the total allowed benefit for a specific service, even with dual coverage.
- Provide Accurate Information: It’s crucial to inform your dentist’s office that you have dual coverage. This allows them to file claims with both plans correctly for proper coordination.
- Review Your Plan Details: Each plan has its own coverage specifics, deductibles, and benefit limits. Carefully review your Delta Dental Plan documents and those of your secondary plan to understand their individual terms.
Wrapping Up
Having dual coverage with Delta Dental can help you get the most from your dental benefits and reduce your out-of-pocket costs.
By learning how dual coverage works and telling your dentist about it, you can make sure you get the best use of your insurance.
Check your plan documents and Delta Dental’s resources for details about your coverage.