Supplemental dental insurance is a secondary dental insurance plan that you purchase to supplement your existing plan. The plan you have now may have long waiting periods or low annual maximums. It's in these cases that another plan could help.
In this article, we'll cover the following:
- How supplemental dental insurance works
- What is coordination of benefits?
- The pros and cons of a secondary insurance plan
- Alternatives for financing your dental work
We hope this information helps you find a supplemental plan that works for you or an alternative way to pay for your dental treatment.
Table of contents
- 1 Understanding supplemental dental insurance
- 2 Supplemental dental insurance for Medicare
- 3 Supplemental dental insurance for existing coverage
- 4 Alternatives to supplemental dental insurance
- 5 4 Ways to finance your dental care
- 6 Reasons to get additional dental insurance
- 7 Pros and cons of supplemental dental insurance
- 8 How to choose a secondary dental insurance plan
- 9 Savings plan as supplemental dental insurance
- 10 Conclusion
- 11 FAQs
Understanding supplemental dental insurance
Around 74 million Americans don't have dental insurance. And many who do still find that their plan doesn't cover the costs they need it to. That's where supplemental dental insurance comes in.
Supplemental dental insurance can be difficult to understand, but essentially, it's an insurance plan that you purchase when you already have dental insurance. Your existing plan may have long waiting periods or a low annual maximum, or maybe it doesn't cover the treatment you need. In any of these cases, you might want to get a supplemental plan to fill in the gaps.
When people refer to supplemental dental insurance, they may be talking about a dental insurance plan to supplement their Medicare insurance, since Medicare Parts A and B don't cover dental. Or, they may be talking about a dental plan to supplement their existing dental insurance.
Many hope that a secondary dental insurance plan can be purchased to cover the gaps left from their existing plan and that the two plans together will result in complete coverage for all treatments needed. Unfortunately, this isn't how it typically works out.
Different insurance companies have complicated ways of collaborating to cover claims. It all comes down to the rules each company has for coordination of benefits.
If you can swing it, you may want to make an appointment to consult a health or dental insurance broker. They are licensed experts in understanding the benefits of insurance plans and could help you make the best choice. You do have to pay for their services.
You can also use an online marketplace like Dentalinsurance.com to look for your dental insurance. They also have a number you can call if you need help.
A knowledgeable insurance expert can explain how everything works and help you figure out the best combination of plans for your needs. Call 888-626-0057 to speak with a helpful, licensed agent now.
Supplemental dental insurance for Medicare
One of the most common reasons someone may be looking for a supplemental dental insurance plan is if they have Medicare. That's because Medicare Parts A and B (the basic level) don't cover dental treatment (with some caveats).
In this case, you can get Medicare Part C, also known as a Medicare Advantage Plan, and look for dental coverage, or you can purchase a standalone dental insurance plan.
We won't go any more into this here, because we have a separate guide that covers everything you need to know about Medicare supplemental dental insurance.
Supplemental dental insurance for existing coverage
A supplemental dental plan for existing coverage may be a good idea for you if you feel like you need extra or full-coverage dental. For example, if you need expensive treatment, like braces or a root canal and a crown, which will end up going over your current plan's annual maximum limit.
Dental insurance plans typically will only cover costs of up to $2,000 per year, some go a bit higher, but not much. This maximum is fine for covering preventative care costs and minor treatments like deep cleaning or dental fillings.
But if you need anything else, you're sure to go over the limit and that means you'll be paying out of pocket.
Another reason you may want a supplemental plan is if your existing plan has a long waiting period for the treatment you need. In this case, you could look for a supplemental plan with no waiting period.
So how does it work?
Your existing dental insurance plan, whether it's one you purchased on your own, or one you're getting through your employer, is your primary plan. When you receive treatment, your dental provider sends the claim to this plan.
If not all of your treatment is covered by the primary plan, then your supplemental plan can take over and help cover some or all of the remaining costs on your dental bill.
Your supplemental plan can't cover treatment until after your primary plan has paid. This is called coordination of benefits (COB).
Coordination of benefits
Let's say you get a root canal for $1000, and your primary insurance plan only pays for $800. You can then submit a claim to your supplemental insurance to cover the remaining $200 balance.
The process isn't always a smooth one, and different companies will have their own ways of coordinating benefits. Thus before you purchase a supplemental plan, you should speak with your current insurance provider to find out how they have set up their coordination of benefits.
Also, before choosing a plan, make sure it will cover the exact treatment you need, because just like regular dental insurance, supplemental plans vary when it comes to what they will cover and how much they will cover.
At this point it would also be helpful to speak with a dental insurance broker, but here are the basics of how COB works:
- Traditional split: You can get up to the full benefits of both policies, with a potential for 100% coverage
- Maintenance of benefits: Your primary plan pays what it normally does, then you pay your deductible and copay for your supplemental plan, at which point it pays for the remaining costs
- Carve out: Your primary plan pays what it normally would, and additional coverage provided by your supplemental plan is paid up to a certain calculated amount, called a ‘cap'
- Nonduplication: Your supplemental plan covers what your primary plan doesn't. However, if the plans cover the same treatment, then your supplemental plan won't pay anything
If you're tearing your hair out trying to figure out how all of this works — stop! Instead, take a deep breath, and call Dentalinsurance.com by dialing 888-626-0057, or go to https://localhelp.healthcare.gov/ to find a licensed health insurance agent or broker who can help you sort this out.
Alternatives to supplemental dental insurance
The primary alternatives to supplemental dental insurance are:
- Dental savings plans
- Dental tourism
Have a look at the table below to find out more about your options:
Another way to finance your dental treatment is with a payment plan. Ask your dentist if this is a possibility. If so, they will come up with a plan for you to pay for your treatment in installments over months, breaking the larger costs up into more manageable amounts.
Reasons to get additional dental insurance
If you're wondering whether or not you should get a supplemental dental plan, we've rounded up the main reasons why you might get one:
- Waiting period: If your current plan has a long waiting period for the treatment you need, a second plan may help you save money on work that you need done now
- Major services: If your current plan only covers the basics, a secondary plan could be handy if you need more extensive work done
- Provider options: If you have two plans, a larger network of providers is likely to be covered
- Annual maximums: Having a second plan can keep you from paying out of pocket once your first plan meets the annual coverage limit
If you want to get started comparing dental insurance plans, you can go to DentalInsurance.com. Simply enter your zip code and date of birth, and this online marketplace will let you browse a wide range of plans available in your state.
Pros and cons of supplemental dental insurance
Still not sure if you should pay for an additional dental insurance plan? Have a look at the following pros and cons:
How to choose a secondary dental insurance plan
While we do recommend you enlist professional help when choosing your secondary plan, here are some things you'll want to consider:
- Understand insurance: You should understand how different types of insurance plans work, including HMOs, PPOs, discount plans, and more
- Determine your needs: Make sure your second plan will provide the coverage for the treatment you need
- Budget: You're trying to save money on dental care, so take a close look at your budget and the costs of a secondary plan, and calculate how much you'll end up saving
- COB: Work closely with a broker to understand how the COB process works with your two plans before making a final decision
Check out the video below for a brief explanation of supplemental dental insurance — and, you'll notice, a recommendation to meet with a broker.
Savings plan as supplemental dental insurance
You may have read about savings plans above, but just in case you missed it, we would be remiss not to emphasize this option.
A dental savings plan (also called a dental discount plan) is not dental insurance. It is a membership that you pay a yearly or monthly fee to be a part of, and in exchange, you get discounted treatment.
No treatments are excluded, and there are no waiting periods or deductibles. That's one of the reasons that a discount plan may be the best supplemental dental ‘insurance' for implants and other expensive dental work.
If you think that a dental savings plan might be a better option for you than a second insurance plan, you can find dental savings plans on DentalInsurance.com as well.
Supplemental dental insurance may help you pay for dental treatment costs not covered by your existing dental insurance plan. For example, if your current plan has an annual maximum of $2,000, but you need a dental implant that costs $6,000, the right secondary plan could help cover the extra costs.
Another way that a secondary plan could be helpful is if your current plan has a long waiting period — you could potentially get around that with a supplemental plan.
However, before choosing a plan, it's important to weigh the pros and cons, and understand how your new plan and your existing plan could potentially work together.
Whether you want an insurance plan or a savings plan to supplement your existing insurance, you can go to DentalInsurance.com and enter your zip code and date of birth to browse a wide range of plans available in your state. You can also call 888-626-0057 to speak to one of their helpful licensed agents.
What is the difference between primary and secondary dental insurance?
Primary dental insurance is your existing dental insurance plan — you might have gotten it through your employer, or your spouse, or you might have bought it on your own. Your secondary insurance is a plan you buy to cover the payment gaps left over from your primary plan.
What is supplemental dental insurance?
Supplemental dental insurance is the addition of a second dental insurance plan to the primary dental insurance plan that you already have. People get supplemental insurance to help cover costs.
Your primary insurance might have low annual maximums, or a long waiting period, or lack coverage for certain treatments that you need. In this case, you might buy another plan.
Can you use two types of insurance for dental?
This depends on the Coordination of Benefits between your two plans. Speak with your insurance company and a health insurance broker to help you figure out if it's worth it to get a second plan.
Theguardian.com: ‘Your Mouth Becomes a Minefield': The Americans who Can't Afford the Dentist. Consulted 25th August 2022.