Dental Insurance Coverages

[dantana]

I need to have major dental work performed with extractions. I have 3 dental plans, a primary, secondary and tertiary. My annual policies limits are below.

Primary - $1500.00
Secondary - $1250.00
Teritary - No Max. Pays $55.00 per extraction

The extractions are going to be performed over the course of several visits, so my question is this. Let's say for the first visit. The total bill is $2000.00 and my primary insurance covers $1,000.00 of that. If my secondary policy also cover at 50% for extractions, would that contribute $500.00 to the remaining balance, so the out of pocket would now be at $500.00? Once it was to this point, let's say that the $500.00 is the cost of 2 extractions, would the teritary kick in and pay $110.00?

I'm looking for in general how this would work? Any assistance would be appreciated.

 

[leevena]

Best for you to call the carriers customer service depts and ask.

 

[somarco]

Why in the hell would anyone pay for 3 dental plans?

Most dental plans have notes that you cannot use in conjunction with other coverage.

If one of them is a cash plan paid direct to you, then you might be able to sneak that one in as a secondary plan.

 

[dantana]

Why in the hell would anyone pay for 3 dental plans?

Most dental plans have notes that you cannot use in conjunction with other coverage.

If one of them is a cash plan paid direct to you, then you might be able to sneak that one in as a secondary plan.

Well, think about it. Let's say that you have major work that needs to be performed that totals $10,000.00 and you have the below 3 policies.

Policy 1
Annual Max: $1500
Co-Pay: 50%
Annual Coverage Cost: $600.00

Policy 2
Annual Max: $1200
Co-Pay: 50%
Annual Coverage Cost: $500.00

Policy 3
Annual Max: $1200
Co-Pay: 50%
Annual Coverage Cost: $500.00

2 Policy Scenario:
Total Dental Work: $10.000
Total Policy Costs: $1100
Total Covered by Insurance: $2700
Total Out of Pocket Costs: $8400

3 Policy Scenario:
Total Dental Work: $10.000
Total Policy Costs: $1600
Total Covered by Insurance: $3900
Total Out of Pocket Costs: $7700

As you can see with 3 policies you're saving $700.00, in reality, it's actually more than that because I went kind've on the high-end for the policy costs.

Thanks for the feedback guys, I'll try contacting my insurance companies and see how all this would work.

 

[somarco]

Most dental plans have notes that you cannot use in conjunction with other coverage.

Good luck with that

 

[leevena]

Off the top of my head, and not knowing anything about the plans nor your dental needs, I would agree with Somarco. Math very rarely works out for you in this scenario.

 

[TN_agent]

If I needed that much work, I would just ask the dentist if he would take $7500 not to have to bill three separate insurances. Betting 9/10 dentists would.

 

[kgmom219]

I don't think its going to work, because Somarco is right, but I disagree on how to go forward. Don't call the carriers.

Ask the dentists office to figure it out. And ask more than 1 dentist, preferably in a different city. Dental prices vary widely between offices.

 

[leevena]

Kgmom. So you want the dentist office to tell policyholder how the carrier will adjudicate the claim?

 

[kgmom219]

Kgmom. So you want the dentist office to tell policyholder how the carrier will adjudicate the claim?

As a first step? Absolutley.

They are the ones with the codes. The carrier is going to give a lot of b "if, and, but statements". Nothing concrete. I would definitely dump it on them. Plus, its dental. Depending on the carrier, they should be able to pre-adjucate the claim at the carrier sites.