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COBs and Your Dental Plan

February 12, 2015


Many of us share more than just memories and affection with our significant other – we share benefits. Dental benefits, to be specific. If your family shares more than one dental plan, it’s referred to as a coordination of benefits (COB).

Here’s how a COB works:

If you have two jobs that both provide dental benefits, or if you are covered by a second dental plan, your benefit plans will “coordinate” your coverage. The two plans work together to make sure you get the most out of your dental benefits. You’ll likely have lower out-of-pocket costs for your dental care.

One plan becomes your primary plan – it pays your claims first. The second plan then pays toward the remaining cost.  

When both plans have COB provisions, the plan in which the patient is enrolled as the main policyholder is primary. The plan in which the patient is enrolled as a dependent serves as the secondary.

Consider this quick example:

Let’s say you visit the dentist to fill a cavity. The dental office will send the bill to your primary dental plan. If that plan covers fillings at 80%, and it was a $100 filling, the plan will pay your dentist $80. Normally, you would owe $20. But, since you have more than one dental plan, you can send the dentist’s bill to your secondary plan. Then, the second company will pay the remaining claim balance.

If the second plan covers fillings at 80%, and it was a $100 filling, it would have paid your dentist $80 if you had no other coverage. However, since you have other coverage, it will pay up to the remainder. So, the second company will pay your dentist the remaining $20.

 To find out if your Delta Dental plan has COB coverage, sign in and review your plan details.

 

 


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