Dental insurance covers the cost of regular dental care, and helps you prepare for unexpected dental surprises in life. Can a person have two dental insurance plans?
What is COB?
Coordination of services (COB) is simply determining from which plan you pay for the patient’s dental care. Benefits from all sources should not exceed 100% of the total fees. When both plans have a COB clause, the base plan in which the patient is enrolled as an employee or as the principal policyholder is considered the original plan. A plan in which the patient is registered as a dependent would be secondary. Sometimes laws and regulations specify benefit coordination or plans will coordinate benefits to avoid over-accumulation or duplication of benefits.
What is the basic plan?
If you decide to get health insurance from both of your employer’s health insurance plans, the basic plan will be the one that will cover the insurance costs first. Generally, a plan that involves you as a registrant is a basic plan and a plan that involves you as a dependent is a secondary plan.
In the case of dependent child insurance, the basic insurance company is usually determined by the birthday rule: the parent’s insurance whose birthday (month and day, not year) is the first of the year, is considered basic child insurance. A divorce contract or other court order may replace the birthday rule.
How does dual range work?
For example, if both of your plans provide for two cleanings a year, each with 80% coverage, then:
- You will not be entitled to four cleanings a year.
- The basic plan pays the benefit as if there was no other insurance
- The second plan will act as a supplement to the original plan and its payments will be limited to reducing its normal benefit or additional patient costs under the original plan.
Double insurance rules
Your plans may provide equal coverage for some procedures, but which plan pays for what?
Your basic plan pays benefits as if you didn’t have an additional insurance plan. If your basic plan and additional plan include two teeth cleaning in a year, you will only be insured for two, not four.
The second healthcare plan complements the basic plan, which may cover some of the other expenses out of pocket.
For example, if both the main and the additional carrier pay 80% for the bridge and the basic plan covers 100 USD, while the second plan covers 80 USD for the same treatment, the additional plan will not make any additional payment.
On the other hand, if the basic plan pays only for 50% of the procedure, while the additional plan covers 80%, then the additional plan can reduce additional costs out of pocket. The exact amount of insurance under the additional plan is based on the coordination of benefits and the lack of duplication of benefits rules.
