What we consume orally, affects the overall health. Regular dental care is important for the well-being of gums, teeth, and overall health. Typically dentists will suggest routine teeth cleaning and procedures like filling and extractions and to avail all such services you need a dental insurance plan that will pay the service charges of the dentist.
Understanding the different terms of dental insurance could be a difficult task. However, these terms will help you understand more about the role of secondary insurance.
An individual can have multiple health insurance plans but having multiple insurances does not mean that the dental insurance provider will be paid twice. It does not even mean that patients can take some money off their dual coverage. Instead, there are two plans; there is one primary and one secondary insurance.
Primary insurance:
If you have multiple healthcare plans then one dental insurance plan is known as primary. Your primary health coverage will pay its portion of a medical claim first. Even if your spouse has another comprehensive plan, your plan will still be primary. In simple words, the primary insurance plan will pay the medical bills first.
Secondary insurance:
The secondary health insurance plan will pay all the remaining costs left by primary insurance care like copayments, deductibles, coinsurance, etc.
Example: Suppose your spouse’s plan covers you too and you have your own insurance plan as well. Your primary health care plan will be your insurance and your spouse’s insurance plan will act as a secondary for you. If you want your dental claims reimbursed then your primary health insurance plan will pay its share first and another secondary plan will pay some percentage of insurance. You may find your secondary insurance of help in lowering your health costs.
Please note that both primary and secondary insurance will cover up to a certain portion of insurance and after the secondary insurance has paid its part, you may be the responsible person for paying the rest amount that was not covered, so no matter how many health insurance policies you have, you may need to pay the leftover amount as out of pocket medical expenses.
Generally, the patients having two insurance policies does not need the copay. In most cases, the secondary policy will cover the copay left by primary insurance. Sometimes secondary policy will also leave some copay and that needs to end up with copay applied to either patient or any other policy of patient.
How do you know which plan is primary and which insurance plan is secondary?
Health insurance policies are covered under the coordination Of Benefits (COB) that allows an individual to have multiple health policies. It also ensures that insurance companies will not reimburse more than their health care costs.
If you are already covered under an insurance plan provided by the employer, you are also covered by your spouse’s plan. Then your plan is known as primary and the other one is known as secondary. Certain rules ensure that persons cannot profit from insurance policies by submitting the same claims to different insurance companies. However, you need to know that having secondary insurance won’t affect the total cost of claims.
Having two dental insurance can help you in many ways. Usually having two dental plans normally cover out-of-pocket, copay, deductible, and other costs. However, there are still some percent of charges that are a patients responsibility and needs to be taken care of by him directly.
