Can you be covered by delta dental and aetna at the same time?
Yes, it is possible to have coverage from both Delta Dental and Aetna at the same time. This arrangement falls under the category of Dual Coverage or Overlapping Dental Coverage. Having insurance from two different companies can provide you with a broader network of providers and enhanced coverage for dental treatments and procedures.
How does Dual Coverage Work with Delta Dental and Aetna?
When you have dual dental coverage, your primary insurance, usually through your employer or individual policy, will cover a certain percentage of eligible expenses based on their coverage plan and limitations. The remaining uncovered costs may then be submitted to your secondary insurance, such as Aetna, for additional coverage.
Here are a few key points to consider regarding dual coverage with Delta Dental and Aetna:
Coordination of Benefits: Each insurance company has its own Coordination of Benefits (COB) rules, which determine the sequence in which they pay claims. Typically, your primary insurer will pay first, and then your secondary insurer would cover the remaining expenses subject to its coverage limits and copayments.
Maximum Allowable Coverage: Both Delta Dental and Aetna may have different maximum allowable coverage amounts for various treatments. You should check with each insurer to understand the specific limitations and restrictions in their plans.
Preauthorization: Certain procedures or treatments may require preauthorization from one or both insurance providers. It is essential to check the requirements for preauthorization and obtain it if needed to ensure your claims are processed without any complications.
Claims Submission Process: You may need to submit claims to your primary insurance first, and then forward the Explanation of Benefits (EOB) or other required documents to your secondary insurer to process the remaining claim.
Provider Networks: Check with both Delta Dental and Aetna to see if your preferred dentists or specialists are part of their networks. This can impact your access to certain providers and the level of coverage you receive.
It is crucial to communicate with your dental providers, insurance companies, and human resources department (if your coverage comes through your employer) to understand your specific coverage details, eligibility, and any limitations associated with dual dental coverage. By effectively managing your dual insurance plans, you can optimize your dental benefits and ensure you receive the necessary coverage for your oral healthcare needs.