Do You Need Secondary Dental Insurance?
Secondary dental insurance, when used strategically, can significantly lower your dental bills.
Many different forms exist, each offering different advantages—and disadvantages.
The key is to understand exactly what supplementary or secondary dental insurance is and obtain the best plan for your unique situation.
“Secondary insurance” is the term used when you already hold one insurance policy and purchase a second plan in order to get more coverage.
The idea is that this second policy will save you even more money out-of-pocket. Understanding just a few details can turn this hope into a reality—but you must understand them.
Supplemental, or secondary plans do not work the same way in the dental health world as they do with medical or general health insurance.
Primary health plans take a good chunk of money off of your bill, and then the secondary health policy takes a chunk of money off of what the first bill left you. Essentially, both plans help with whatever procedure your bill was for.
With secondary dental insurance, though, while you can legally hold more than one policy, no policies are allowed to be combined. If you choose Plan A for Procedure 1, then only Plan A can help with Procedure 1. You can use Plan B, but it must be for a different Procedure 2 at a different visit to the dentist.
Sound complicated? It can be.
You will want to know ahead of time what plan will cover more of the cost for each specific procedures you need performed. That usually takes some work to figure out.
However, a few simple tips allow you to do this much more quickly and painlessly.
When comparing two dental plans, ask yourself these questions:
1. Does either plan have a deductible?
Tip: In order to be able to use both of your plans, you need to meet any deductibles specified in each plan. This might mean that you would use one plan for your first visit, and the secondary dental insurance for your next visit to the dentist. Make sure to read the fine print in your plans, though. Some plans do not count certain procedures toward the deductible. For example, often whatever dollar amount you pay for cleanings cannot be added into the amount you need to pay to meet the deductible.
Often, dental insurance plans require that you pay a certain amount out of pocket before they will start chipping in on your costs. This amount is called a deductible.
To understand how deductibles work, say one of your companies has a deductible of $50, and say you need a filling that normally costs $200. If this plan is a high-end (high monthly premiums) plan, it might pay as much as 80% of basic restorative procedures like fillings.
How do you know what you will pay the dentist? First take out the deductible, $50, from the normal price, $200: $150. Now, since the company pays 80%, take 20% of $150: $30. Your portion of this bill would be $50 plus $30, so your filling costs you $80.
2. Does either the primary or the secondary dental plan have certain procedures covered at 100%?
Tip: if this is the type of plan that you have purchased, check (and even memorize) the list of procedures that the company takes care of completely. Make sure to always use this plan for that list of procedures. After all, it does not make any sense to pay 40% for a cleaning when you can get it for free with another plan!
Only high-premium insurance plans cover 100% of even a few procedures. This is because it is very expensive for companies to pay your whole dental bill, so they pass these expenses on you their customers in high monthly or annual premiums.
Even when some procedures are covered at 100%, no companies (that this author knows of) cover all procedures at 100%.
3. Does either dental plan have a maximum annual limit?
Insurance plans usually place limits on how much dental work they will help pay for within a year. Some of these limits are “maximums,” or spending caps. Maximums are almost always between $1,000 and $1,500 for an individual.
At first glance, those numbers look deceivingly large.
Let’s see how a plan with a $1,200 maximum works out for two people, Randy and Sallie. (Note: The costs for procedures are the total billed to the insurance. Each person would pay a co-payment for these procedures as well as any out of pocket costs.)
Sallie maintains good oral hygiene and has naturally healthy teeth. She sees her dentist twice a year for her cleanings ($85 each) and basic oral examinations ($47 each), and she keeps up with her annual full-mouth x-rays ($118).
If she never has any other problems, she will only need to pay her portion for each of those procedures. However, if she even needs as little as three fillings that year ($213 per filling, $59 for x-rays for each), Sallie will hit her maximum. Anything further that crops up will be out of her pocket.
Randy takes fine care of his teeth, but he has had pain in the back of his lower jaw for some time now.
After his diagnostic visit with the dentist, comprised of a comprehensive oral exam ($81) and full-mouth x-rays ($118), Randy’s dentist tells him that he needs a root canal. That alone will cost $923, plus the $62 for local anesthesia.
To make matters worse though, Randy’s dentist says that he will need a crown to keep the tooth safe from cracking (resulting in permanently losing the tooth) after its interior is removed. The crown’s price is $940.
Though Randy will be paying his copay for each of the procedures along the way, he will still have to pay an additional $884 out of pocket at the end.
Moreover, he cannot get any help for his basic dental needs throughout the rest of the year—cleanings, fluoride treatments, or simple fillings.
Overall, the typical maximum works great for people who have no dental problems, but…
maximums can really short-change you if you have something unexpected crop up.
Find out how you can save up to 60% without worrying about maximums
Other limits usually involve how often you can get certain procedures done—and have the benefit of the company helping you pay for them.
For example, most dental insurance companies limit you to two cleanings per year and one set of x-rays. If you have already had your x-rays for the year and months later discover a deep pain in your jaw, that next round of special pictures might be on you.
Tip: If you have a dental insurance policy through an employer already, check the maximums and other limitations. Next, estimate what work you might need performed this year. Leave plenty of “wiggle room” for those unexpected problems. Finally evaluate how much of a risk you are willing to take. If you want to be very secure, start shopping for secondary dental insurance.
If you already have a dental insurance policy that you have purchased for yourself, seriously weigh the costs versus the benefits of maintaining your plan.
Often insurance companies set maximums that are just two to five times as much as your annual premium.
Factor in the amount you spend annually in co-payments. Now, add in the risk that you might exceed your maximum and then have to pay even more out of pocket.
Sometimes you break even at best with individual dental insurance plans. In this case, purchasing a secondary plan fails to rescue you from the actual problem.
Suggestion, if I may?
Dental insurance is expensive to hold, even when you just hold one policy. Holding two actual insurance policies at once can get downright brutal for your wallet.
Click Here to See a Plan That Saved Me Over $3,000 in Six Months
If you already have an insurance policy but need additional help, I would consider obtaining a discount dental plan for your second plan.
Discount plans are much cheaper per month (as low as $16 for a family, compared to $33 for family dental insurance), making them an easier expense to tack on to that ever-tightening budget.
Discount plans essentially have negotiated with dentists and gotten them to reduce their prices for plan members.
Being a member of a discount plan is like being a member to Sam’s or Costco—you have to buy the membership, but once you do, you get access to much cheaper prices for everything there.
Like insurance, some discount plans carry more bang for your buck than others.
Some plans come as a package, including vision and even prescription discount plans as part of your membership.
Sometimes discount plans will have procedures on their plans that normal insurance does not cover, like braces (even for adults), whitening, and dental implants. Just be a smart consumer, like you already are, and compare plans based on monthly premiums, discounts offered and any limitations.
Pick the plan that fits you best, and watch your wallet bulk back up with all that cash you’re saving!
P.S. If you want a place to start your discount plan search, check out this dental discount plan. It has saved the author more than $3,000 in less than six months, as mentioned previously:).