What will the secondary plan pay?
Enter the fee, what the primary plan paid and the secondary plan's numbers. See both common ways the secondary plan works out its share.
Runs in your browser. Nothing you type is sent to Tabruns or saved, and it asks for no patient details. Plans differ: the insurer decides what it pays. In network, any contract write-off comes off the balance first.
Which rule does the plan use?
The secondary plan's documents say, often under “coordination of benefits”. If it says the plan won't pay more than it would have as primary minus what other plans paid, that's nonduplication (sometimes called carve-out). Ask the insurer when it isn't clear, and see the coordination of benefits and nonduplication entries in the billing glossary.
Questions
How does secondary dental insurance pay?
The primary plan pays first. The secondary plan then works out what it would have paid on its own and pays toward the balance left. How much depends on its coordination rule: standard coordination pays up to that amount, nonduplication takes off what the primary already paid.
What is nonduplication of benefits?
A rule where the secondary plan pays only the difference between its own normal benefit and what the primary paid. If both plans pay 80%, the secondary pays nothing more. If the primary pays 50% and the secondary normally pays 80%, the secondary pays up to the other 30%.
Which plan is primary for a child on both parents' plans?
Usually the plan of the parent whose birthday (month and day) comes first in the year, the birthday rule. A court order can change that.
Does the secondary plan use up its own yearly maximum?
Yes. What it pays comes out of its own maximum and deductible, so enter what's left of both.
Let the benefits page do the typing
Tabruns Dental gives the primary plan's estimate in dollars from the benefits page you already have open. Start there, then use this page for the second plan.
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