Monday, November 16, 2009

Dental Insurance - Coordination of benefits?

If I sign my wife and I up with my employer, $1500 max for my wife, and she also signs up for dental insurance through her employer, $1000 max for the year, would it be worth it?





She needs to have a tooth extracted, and will need either a bridge or an implant, which are covered at 50%. Would this effectively make it paid for at 100% through COB?

Dental Insurance - Coordination of benefits?
Best answer is yes, but read the plans very carefully...they can be tricky. Also, ask your dentist how much the total charges will be. They may be less than you are thinking. Don't forget to figure in your deductibles and co pays.
Reply:not worth the effort
Reply:most dental providers will not bill secondary ins companies. most states will make her bill her insurance first and then you can bill yours. if there is a deductable on your plan it would not be worth. but will be better than one or no coverage.good luck
Reply:It would make sense to have both of the insurances as it will help out with costs. Many times you would have no copay at all. One thing to be careful about. Many insurances do have clauses so they do not have to pay out the money. Some of them require you to have the insurance for a certain period of time before they will cover major work. Many insurance will not cover the bridge if a tooth is missing on the other side of the mouth. Also, many insurances will not cover the bridge if the tooth was taken out prior to receiving this insurance, existing condition clause. I hope this helps you. Most of the time it is best to have the duel insurances, just do not assume. My office will bill both insurance companies and I believe many others will also.
Reply:You might find out that either one of your employers will disqualify you from one of their group plans if you already have insurance through another. Contact your HR department to find out! You should look into Flexible Spending Accounts (FSA's) if either one of your employers offers it. They are funds in which you can have your employer deduct money from your paycheck on a before tax basis for you to use to pay for your out-of -pocket medical expenses, co-payments, and other health related expenses such as eyeglasses. You can chose how much you with hold from your check (paid weekly, the total you specify divided by 52) Periodically you fill out a claim form with receipts for your covered expenses. The savings come from not paying taxes on this money, which can save you hundreds of dollars over the course of a year and more if you are planning expense procedures. The catch is that you must submit paperwork to be reimbursed and you must use all of the money that you set aside in that given calendar year, so be careful estimating what you medical expenses are going to be. Also there are some rules about what qualifies as a medical expense, for instance prescriptions are covered but vitamins are not. Get a full list of from your HR department of what qualifies and what doesn't to be safe.


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