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HomeMy WebLinkAboutCoordinating Two Dental PlansMAKE THE MOST OF YOUR BENEFITS As soon as you’re covered under two dental carriers, let your dental office know. Delta Dental will coordinate with your other carrier to share the cost of your treatment. BASIC CONCEPTS > When you’re covered under two plans, one plan is considered your primary carrier. This carrier will pay a larger portion of your benefits, leaving a smaller amount to your secondary carrier. You can find out how to identify your primary carrier on the back of this flyer. > Check the plan booklet for your secondary carrier to see if you have a non-duplication of benefits clause. If you do, your benefit will be slightly less than standard dual coverage. > Review your Evidence of Coverage, Summary Plan Description or Group Dental Service Contract for specific details about your plan. COORDINATING TWO PLANSBEST OF BOTH Are you or your family members covered under two dental plans? Dual coverage doesn’t mean your benefits are doubled, but it can mean added savings on dental costs. DELTA DENTAL PPOSM DELTA DENTAL PREMIER® WE KEEP YOU SMILINGdeltadentalins.com/enrollees Copyright © 2015 Delta Dental. All rights reserved. EF9 # 84157 (rev. 12/15)CUSTOMER SERVICE Delta Dental of California: 800-765-6003 California School District Employees: 866-499-3001 Delta Dental of Delaware; Delta Dental of the District of Columbia; Delta Dental of New York; Delta Dental of Pennsylvania (and Maryland); Delta Dental of West Virginia: 800-932-0783 Delta Dental Insurance Company (Alabama, Florida, Georgia, Louisiana, Mississippi, Montana, Nevada, Texas, Utah): 800-521-2651 Our Delta Dental enterprise includes these companies in these states: Delta Dental of California — CA, Delta Dental of Pennsylvania — PA & MD, Delta Dental of West Virginia, Inc. — WV, Delta Dental of Delaware, Inc. — DE, Delta Dental of New York, Inc. — NY, Delta Dental Insurance Company — AL, DC, FL, GA, LA, MS, MT, NV, TX and UT. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania, Delta Dental Insurance Company and our affiliated companies form one of the nation’s largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies that together provide dental coverage to 68 million people in the U.S. Delta Dental Premier and Delta Dental PPO are underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV, TX and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental PPO is underwritten as a Dental Provider Organization (DPO) plan. HOW DOES DUAL COVERAGE HELP ME SAVE? How much you save depends on whether your secondary carrier has a non-duplication of benefits clause.1 EXAMPLE: Both your primary and secondary carrier cover your procedure at 80%. Type of Coverage Primary Carrier Pays Secondary Carrier Pays Your Coverage Pays No dual coverage 80%N/A 80% Standard dual coverage 80%80%100% Dual coverage with non- duplication of benefits 80%80%80% You are responsible for any applicable deductibles, coinsurance, amounts over plan maximums and charges for non-covered services. WHICH IS MY PRIMARY CARRIER? You are... a dependent child an adult No Do they have joint custody? Are your parents married and living together? Are you covered through your spouse or domestic partner? Your primary carrier is... through the parent whose birthday (month and day) falls earlier in the year. If both parents have the same birthday, your primary carrier is the one you’ve been covered under longer. Yes Yes Your primary carrier is... the one provided by your employer. Your primary carrier is... through the parent with legal custody. Coverage is usually determined in the following order2: Custodial parent > custodial stepparent > non-custodial parent > non-custodial stepparent Your primary carrier is... the one that has covered you longer. Your primary carrier is... the one provided by your current employer. No NoYes your former employer (laid off or retired) another current employer (you have two jobs) Coverage is through both your current employer and... 1 If your primary or secondary carrier is an HMO-type plan, please contact Customer Service for details. 2 If a court decree establishes a different order of benefits for a dependent child’s coverage, that decision applies instead.E