Pros And Cons Of Having Two Dental Insurance

Having dental insurance is essential for protecting your family from expensive medical costs. But what happens when you and your partner both have insurance plans? You might think that having two plans would provide double the protection, but that’s not always the case. Let’s explore the pros and cons of having two dental insurance plans and how it can sometimes leave you feeling like you have no coverage at all.

Pros And Cons Of Having Two Dental Insurance
Pros And Cons Of Having Two Dental Insurance

The Double Coverage Dilemma

Lauren and Chris Lewis thought they were fully covered when their son Langston was born. They both had separate insurance plans, so they assumed any medical expenses would be taken care of. However, they soon discovered that having two insurance plans can lead to complications and confusion.

After Langston’s birth, the Lewises received an unexpected bill from Baylor, Scott & White Hospital for over $4,000. Despite negotiating with both insurance companies for a year, neither plan agreed to cover the bill. The Lewises were left wondering if they would have to pay out of pocket for the costs, which seemed unfair and confusing.

The Rules and Conflicting Insurance Plans

The reason insurance companies can decline to pay medical expenses covered under their plans lies in the rules and regulations. Langston’s mother had health coverage with United Health Care, which followed the “birthday rule.” This rule states that when both parents have separate insurance plans, the parent whose birthday falls first in the calendar year is responsible for covering the birth of the child. In this case, Langston’s father would be the primary insurer.

The problem arises when different insurance plans have conflicting rules. Langston’s father had insurance with Care First Blue Choice, which stated that when both parents have insurance, the cost of the baby goes to the mother’s insurance. With two insurance companies playing by different rules and pointing fingers at each other, the Lewises found themselves stuck with the bill.

The Fractured System of Health Insurance

The fractured system of health insurance in the United States often leaves consumers in difficult situations. Not all insurance plans are regulated by the same government agency, which means they don’t have to follow the same rules. Employer-sponsored health plans in Texas are regulated by the U.S. Department of Labor, while fully insured plans are regulated by the Texas Department of Insurance. Additionally, there are government plans like Medicare, Medicaid, and military plans that have their own regulations. This fragmented system can lead to confusion and patients falling through the cracks.

Seeking Solutions

To address this issue, federal lawmakers introduced the Empowering Parents Health Care Choice Act. If passed, the bill would grant parents with dual insurance plans the right to choose which plan serves as the primary insurer. However, this law would only apply to health plans regulated by the federal government, leaving out a significant portion of the population.

While progress has been made in terms of transparency and hospital pricing, the system is still far from perfect. Patients often find themselves in emotional battles with insurance companies when their claims are denied or not covered as expected. The Texas Department of Insurance offers a helpline for assistance, but their reach is limited to plans regulated by the state.

Conclusion

Having two dental insurance plans can be both a blessing and a curse. On one hand, it may seem like you’re getting extra coverage, but the conflicting rules and fragmented system of health insurance can leave you feeling unprotected and stuck with unexpected bills. It’s important to understand the rules of your insurance plans and seek help when needed. Remember, when it comes to dental insurance, knowing your rights and navigating the system can make all the difference.

For more information on dental insurance and other health-related topics, visit Make You Smile.