Can I Purchase Additional Dental Insurance? A Deep Dive

The short answer is a resounding yes, you can typically purchase additional dental insurance. However, the real question isn’t can you, but should you? Let’s unpack this complex issue and explore the nuances involved.

Understanding Supplemental Dental Coverage

Supplemental dental insurance, often referred to as secondary dental insurance, is exactly what it sounds like: an additional dental plan on top of your existing coverage. People often consider it when they feel their primary dental insurance doesn’t provide adequate coverage, particularly for expensive procedures like implants, orthodontics, or major restorative work. Before jumping into another policy, it’s crucial to thoroughly understand how dual dental coverage works.

How Dual Dental Coverage Works

When you have two dental insurance policies, a process called coordination of benefits (COB) comes into play. COB dictates which insurance pays first and which pays second. Generally, the plan covering you as a dependent (e.g., through a spouse’s employer) is secondary to your own employer-sponsored plan. However, specifics can vary widely depending on the insurance companies and the type of plans you have.

Potential Benefits of Additional Dental Insurance

Why would someone want additional coverage? Here are a few common reasons:

• Increased Coverage Limits: Many primary dental insurance plans have annual maximums that can be quickly exhausted with significant dental work. A secondary plan can effectively double your coverage.
• Broader Network: If your primary plan’s network is limited, a secondary plan with a different network could provide access to a wider range of dentists.
• Coverage for Services Not Covered by Primary Plan: Some plans exclude certain procedures. A secondary plan might offer coverage for those services.
• Reduced Out-of-Pocket Costs: Even with copays and deductibles, having two plans can significantly lower your final expenses, especially for costly treatments.

Potential Drawbacks of Additional Dental Insurance

Despite the potential benefits, there are also considerations that might make additional coverage less appealing:

• Cost: Two premiums mean double the expense. You need to carefully calculate whether the potential savings outweigh the additional cost.
• Coordination of Benefits Complexity: Navigating the COB process can be confusing and time-consuming. Paperwork, phone calls, and potential delays are common.
• Limited Actual Benefit: COB doesn’t always result in significant savings. Some secondary plans only pay the difference between the primary plan’s payment and the dentist’s charge, up to the secondary plan’s allowed amount. In some cases, the combined payment is simply the full amount of the dental bill.
• Waiting Periods: Many dental insurance plans, including supplemental ones, have waiting periods for major procedures, typically six months to a year.
• Exclusions and Limitations: Both your primary and secondary plans will have their own exclusions and limitations. Read the fine print carefully.

Making an Informed Decision

Before purchasing additional dental insurance, take these crucial steps:

1. Understand Your Existing Coverage: Thoroughly review your primary dental insurance policy to understand its coverage limits, exclusions, and network.
2. Estimate Your Dental Needs: Consider your current dental health and anticipate future needs. If you know you’ll need expensive procedures soon, supplemental insurance might be worth considering.
3. Compare Different Plans: Research and compare different supplemental dental insurance options. Pay attention to premiums, deductibles, copays, coverage limits, waiting periods, and network restrictions.
4. Contact Insurance Providers: Speak directly with insurance providers to clarify any questions about their policies and the COB process. Get written confirmation of how benefits will be coordinated.
5. Consult Your Dentist: Discuss your insurance options with your dentist. They can provide valuable insights into the potential costs of your dental care and help you determine if supplemental insurance is beneficial.
6. Do the Math: Calculate the potential savings of supplemental insurance versus the cost of premiums, deductibles, and copays.

Frequently Asked Questions (FAQs) about Additional Dental Insurance

1. Is it legal to have two dental insurance plans?

Yes, it is perfectly legal to have two dental insurance plans. There are no laws prohibiting individuals from holding multiple insurance policies, including dental insurance.

2. How does coordination of benefits (COB) work in dental insurance?

Coordination of benefits (COB) determines which insurance plan pays first when you have multiple policies. Typically, the primary plan pays first, and the secondary plan then covers remaining eligible expenses, up to its own limits. Rules vary, so confirm with both insurers.

3. Will having two dental insurance plans always result in lower out-of-pocket costs?

Not necessarily. While having two plans can reduce out-of-pocket costs, the savings depend on the specific terms of each plan, the costs of the dental services you receive, and how well the plans coordinate benefits. The added premium cost can sometimes negate any savings.

4. Can I submit the same dental claim to both insurance companies?

Yes, you will generally submit the claim to your primary insurance first. Once you receive the Explanation of Benefits (EOB) from the primary insurer, you will then submit the claim, along with the primary insurer’s EOB, to your secondary insurance.

5. Are there any restrictions on the types of dental insurance I can have as a secondary plan?

Generally, no. You can typically choose any dental insurance plan as a secondary plan, regardless of the type of plan (e.g., PPO, HMO, indemnity). However, it’s crucial to understand the specific terms and limitations of each plan to ensure it complements your primary coverage effectively.

6. What is a “non-duplication of benefits” clause in dental insurance?

A “non-duplication of benefits” clause means that the secondary insurance will only pay the difference between what the primary insurance paid and the total cost of the dental service, up to the secondary plan’s maximum allowable amount. This prevents you from receiving more than 100% of the cost of your treatment. Some plans have this clause, making a secondary plan less beneficial.

7. Is it worth getting additional dental insurance if my employer already provides good coverage?

That depends on your individual needs. If your employer’s plan has high coverage limits, a broad network, and low out-of-pocket costs, additional coverage might not be necessary. However, if you anticipate needing expensive procedures or want access to a wider range of dentists, supplemental insurance might be worthwhile.

8. How do waiting periods work with secondary dental insurance?

Waiting periods typically apply to both primary and secondary dental insurance plans. This means you may need to wait a certain period (e.g., six months to a year) before certain procedures, like major restorative work, are covered by the secondary plan, even if your primary plan covers them immediately.

9. Can my secondary dental insurance deny coverage if my primary insurance has already paid?

No, your secondary dental insurance cannot simply deny coverage because the primary insurance has already paid. They are obligated to coordinate benefits and pay their portion of the eligible expenses, up to their plan limits, according to the COB rules.

10. What should I do if I have trouble coordinating benefits between my two dental insurance plans?

If you encounter issues coordinating benefits, contact both insurance companies and explain the situation. Keep detailed records of all communications and documentation. If the issue persists, consider filing a complaint with your state’s insurance department.

11. Does the IRS consider dental insurance premiums tax deductible?

Dental insurance premiums can potentially be tax deductible as a medical expense, but only to the extent that your total medical expenses exceed 7.5% of your adjusted gross income (AGI). Consult with a tax professional for personalized advice.

12. Where can I find reputable supplemental dental insurance plans?

You can find supplemental dental insurance plans through various sources, including insurance brokers, online insurance marketplaces, and direct contact with insurance companies. Research different options carefully and compare plans based on your individual needs and budget. Consult consumer reviews and ratings to assess the reputation of different insurers.

Ultimately, the decision of whether or not to purchase additional dental insurance is a personal one. By carefully evaluating your existing coverage, anticipated needs, and the costs and benefits of supplemental insurance, you can make an informed decision that best suits your individual circumstances.