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Insurance and Billing

Coordination of benefits

Coordination of benefits decides which plan pays first when you have two or more plans covering the same dental claim.

Coordination of benefits is a way to figure out who pays first when two or more plans are responsible for the same claim. The plan that pays first is the primary plan. The other is secondary.

NADP gives an example: if a child is on both parents' dental plans, one plan is primary and pays first. The second plan pays after, and its payment often covers part of the balance. State rules differ on how much the second plan pays, so check with your plan.

The two plans together do not pay more than the allowed charges. You still may owe your deductible or coinsurance. Give the dental office both plans when you check in so each claim goes to the right place. See dental insurance.

Related terms

Sources

  1. HealthCare.gov Glossary: Coordination Of Benefits
  2. National Association of Dental Plans: Glossary of Dental Insurance Terms
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