Dual dental insurance means having two different dental insurance plans at the same time. This can happen if you have two jobs that each offer dental benefits or if you are covered by your own plan and also by your spouse’s dental plan. Dual coverage does not mean you get double the benefits, but it can help reduce your out-of-pocket costs for dental treatments.
For example, if you need a root canal or treatment for caries (cavities), having dual insurance may help cover more of the costs than a single plan alone.
Types of Dual Dental Insurance Plans
There are mainly two types of dental insurance plans that can work together in dual coverage:
Group Plans: These are plans provided by employers. Dual coverage usually applies only to group plans, not individual plans. When you have two group plans, they coordinate benefits to share costs.
Combination of PPO and HMO Plans: Sometimes, one plan may be a Preferred Provider Organization (PPO) and the other a Health Maintenance Organization (HMO). Coordination between these can be more complex, but it is possible to have dual coverage involving these types.
In dual coverage, one plan is called the primary plan, which pays first, and the other is the secondary plan, which pays after the primary plan has paid its share. The primary plan usually covers a larger part of the bill, and the secondary plan may cover some or all of the remaining costs.
Advantages of Dual Dental Insurance
Dual dental insurance offers several benefits:
Lower Out-of-Pocket Costs: If your primary plan does not cover the full cost of a procedure, such as a root canal or filling for caries, your secondary plan may cover part of the remaining balance. This reduces what you pay out of pocket.
Access to More Dentists: Having two plans often means access to a larger network of dental providers. You can choose your preferred dentist or specialist more easily.
More Coverage for Treatments: Some plans limit the number of certain treatments per year, like cleanings. Dual coverage can allow you to get additional treatments without extra cost.
Supplemental Coverage: Dual insurance can act as supplemental coverage, helping pay for treatments not fully covered by your primary plan.
Coverage of Dual Dental Insurance
Dual dental insurance covers many common dental treatments, including preventive care and more complex procedures:
Preventive Care: Cleanings, exams, and X-rays are often covered by both plans. However, dual coverage does not double the number of cleanings you can get in a year; the plans coordinate benefits to avoid duplication.
Basic Procedures: Fillings for caries, simple extractions, and root canals may be partially covered by both plans, reducing your overall cost.
Major Procedures: Crowns, bridges, and other major dental work can also be covered, with costs shared between the two plans.
Limitations: Some plans have a non-duplication of benefits clause, meaning the secondary plan will not pay if the primary plan has already paid the maximum allowed for a procedure.
Related Costs of Dual Dental Insurance
While dual dental insurance can save money, there are some costs to consider:
Premiums: You pay premiums for both plans, which can add up.
Deductibles and Co-pays: You may still have to pay deductibles or co-pays, depending on each plan’s rules.
Out-of-Network Charges: If you see a dentist outside the plan’s network, you might pay more, and dual coverage may not fully cover these charges.
Non-Covered Services: Some dental treatments might not be covered by either plan, leaving you responsible for the full cost.
Advantages and Disadvantages of Dual Dental Insurance
| Advantages | Disadvantages |
| Reduces out-of-pocket costs for treatments like root canals and caries fillings | Does not double benefits; coverage limits still apply |
| Access to a larger network of dentists and specialists | Paying two premiums can be expensive |
| Can cover additional treatments beyond single plan limits | Coordination of benefits can be complex and confusing |
| Secondary plan may cover costs not covered by primary plan | Some plans have clauses that limit secondary coverage (non-duplication clause) |
| Helps with major dental procedures by sharing costs | Must inform dental office about both plans to avoid claim issues or fraud |
Conclusion
Dual dental insurance can be a valuable tool to help manage the costs of dental care, such as treatments for caries or root canals. It provides access to more dental providers and can reduce your out-of-pocket expenses by coordinating benefits between two plans. However, it does not double your coverage, and there are costs and complexities involved.
Understanding how primary and secondary plans work, and checking for clauses like non-duplication of benefits, can help you maximize the advantages of dual dental insurance while avoiding potential pitfalls. Always inform your dental office about your dual coverage to ensure smooth claim processing and savings.
