Author Topic: Using 2 different dental insurance plans for one kids braces  (Read 2700 times)

Offline shidduch

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Using 2 different dental insurance plans for one kids braces
« on: September 18, 2014, 09:03:19 PM »
Anyone have experience using two dental insurance companies to pay for braces.
My wife has metlife and I have delta and we would like to use both to cover the majority of the costs. Mine is the primary. Has anyone had experience dealing with this.

Offline yos9694

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #1 on: September 19, 2014, 01:00:02 PM »
You need to check with your wife's plan about coordinating the coverages. If her plan is secondary then you would submit your claim there after getting an EOB from the claim you make to your plan.

A simple example of how coordinated coverage works: if your plan covers 50% and hers covers 50%, then hers will pay nothing. If hers covers 60%, then hers will pay 10%. Of course this is not the only way it can work, but it's generally true.

If you thought you would get 50% back from yours and another 50% back from hers, that is you-know-what.

Offline myb821

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #2 on: September 19, 2014, 01:05:19 PM »
You need to check with your wife's plan about coordinating the coverages. If her plan is secondary then you would submit your claim there after getting an EOB from the claim you make to your plan.

A simple example of how coordinated coverage works: if your plan covers 50% and hers covers 50%, then hers will pay nothing. If hers covers 60%, then hers will pay 10%. Of course this is not the only way it can work, but it's generally true.

If you thought you would get 50% back from yours and another 50% back from hers, that is you-know-what.
i dont think you are total and just googling coordination of benefits example this is the first link. http://www.4j.lane.edu/files/benefits/4J_BENE_Coordination_Example.pdf

Offline stevento

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #3 on: September 21, 2014, 09:44:24 AM »
You need to check with your wife's plan about coordinating the coverages. If her plan is secondary then you would submit your claim there after getting an EOB from the claim you make to your plan.

A simple example of how coordinated coverage works: if your plan covers 50% and hers covers 50%, then hers will pay nothing. If hers covers 60%, then hers will pay 10%. Of course this is not the only way it can work, but it's generally true.

If you thought you would get 50% back from yours and another 50% back from hers, that is you-know-what.

what you're referring to is "non-duplication of benefits".
Coordination of benefits is something else.
If your Delta pays 50% of the charges up to $2000, and your wife's Metlife pays 50% of the charges up to $2000, and your bill is $4000, Delta will pay half, then Metlife will pay half of the half...and your portion is 25%.
If your bill is $5000, then Delta will pay $2000, and Metlife will pay $1500, and your portion is $1500. 
Does that make sense?

Make sure Delta is primary.  If it is secondary, it frequently has non-duplication of benefits, in which case it will pay nothing.


Offline myb821

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #4 on: September 21, 2014, 09:46:00 AM »
ive never heard of non duplication b4, interesting.

Offline Menachem613

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #5 on: September 21, 2014, 09:58:14 AM »
How would your insurance company know about the other?

Offline stevento

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #6 on: September 21, 2014, 10:11:16 AM »
ive never heard of non duplication b4, interesting.

it's not common...Delta "likes" it a lot  >:(

Offline yos9694

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Re: Using 2 different dental insurance plans for one kids braces
« Reply #7 on: October 12, 2014, 12:17:39 AM »
what you're referring to is "non-duplication of benefits".
Coordination of benefits is something else.
If your Delta pays 50% of the charges up to $2000, and your wife's Metlife pays 50% of the charges up to $2000, and your bill is $4000, Delta will pay half, then Metlife will pay half of the half...and your portion is 25%.
If your bill is $5000, then Delta will pay $2000, and Metlife will pay $1500, and your portion is $1500. 
Does that make sense?

Make sure Delta is primary.  If it is secondary, it frequently has non-duplication of benefits, in which case it will pay nothing.

Coordination of benefits is exactly that. "Non duplication of benefits" is simply a term (Delta's?) that describes coordination more clearly to the layperson.