FALLS CHURCH, Va. –
Do you or your spouse have another dental insurance plan in addition to the
TRICARE Dental Program? Did you know you can use both? Not only could coordinating dental plans provide extra coverage, you could also lower out-of-pocket costs. If you’re wondering how to navigate your dental care between two plans, this article will explain what coordinating those plans means and point you to resources to answer your questions.
How coordinating dental insurance policies works
If you have other dental insurance, United Concordia, the administrator of the TDP, will work with your other insurance company and apply the coordination of benefits rules, so you won’t have to.
Here’s what to know about having two dental insurance policies
There are some rules that determine whether the TDP is the primary or secondary dental insurance when it comes to paying for your dental care. The primary plan pays first, and the secondary plan pays second.
The TDP as the primary plan
The TDP is the primary plan when your spouse or child doesn’t have their own dental plan. Submit the claim first to United Concordia. If you use a TDP network dentist, they’ll submit the claims for you. Looking for a network dentist? Use the Find a Dentist Tool.
The TDP as the secondary plan
The TDP is the secondary plan when your spouse or child has their own dental plan. When the TDP is the secondary plan, the claim goes to the other insurance company first before the TDP.
How does the TDP work as a secondary plan? The primary plan pays benefits without regard to the secondary plan. If the TDP is your secondary plan, it will pay up to the usual allowable charges for any TDP covered services not paid by your primary plan. When the TDP is your secondary plan, it will never pay more than your dentist charges, nor more than it would have paid as the primary insurance plan. Together, your primary and secondary coverage combined can never exceed the dentist’s charge.
Exceptions to the rule
The following situations are exceptions involving children:
- Birthday rule. If you and your spouse both have dental plans, the “birthday rule” usually determines the primary plan for your child’s coverage. The primary plan belongs to the parent whose birthday falls earlier in the year.
- For example, if the mother’s birthday is March 2 and the father’s birthday is March 12, the mother’s dental plan is primary.
- Gender rule. For some insurance companies, the “gender rule” may determine the primary plan for your child’s coverage instead. According to the gender rule, the male parent’s dental plan is always the primary plan. If your other insurance company uses this rule, United Concordia will, too.
- Custody rule. If you and your child’s other parent aren’t married and both have dental plans, the insurance plan of the parent with custody is the primary plan.
- If the parent with custody remarries, the stepparent’s plan will provide secondary coverage before the plan of the parent without custody.
- If there is a court decree declaring which parent is responsible for insurance coverage, the decree takes precedence.
- You can send any custody agreements to United Concordia through the online form available at www.uccitdp.com.
Have more questions about coordinating dental plans? Check out the TRICARE Dental Program Handbook for more information. Or call customer service at CONUS toll-free: 844-653-4061 or OCONUS toll-free: 844-653-4060 (view the AT&T access codes).
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