If you have a GEHA PPO Dental insurance policy in addition to a second insurance policy, this can greatly reduce your out of pocket copay for dental care. Sunnyvale Dentist Dr. Gupta is a GEHA PPO (Preferred Provider Organization) Dental insurance provider.
You may have a GEHA PPO Dental insurance policy through your job and additional coverage through your spouse or domestic partner. Children are sometimes covered under two parents’ plans. Primary and secondary insurance companies coordinate to pay your dental claims. Dual coverage works the same whether you have two GEHA PPO Dental insurance plans, or plans from GEHA and another carrier. The amount paid by both plans will not exceed the total amount of the dental claim.
Some plans have a non-duplication of benefits rule. Under this rule if both insurance plans cover fillings at 60% and the primary plan has paid its 60%, the secondary plan would not pay any additional amount.
In standard coordination of benefits if you have a filling that is covered at 60% by the primary insurance company, the secondary insurance company would pay the additional 40%. Unfortunately the insurance companies are the only ones who can decide which policy to use as primary and which to use as secondary.
The insurance coordinator at Sunnyvale Dental Care will be happy to contact GEHA PPO Dental insurance and any other insurance company to verify how each will be covering your claims.
The dental insurance that you receive through your employer is your primary insurance. If you have coverage from two employers, the insurance through the employer that you’ve worked for the longest would be considered your primary insurer. Coverage from any source other than your employer would be secondary insurance.
For children who have GEHA PPO Dental coverage through one parent and additional coverage through the other parent, the parent whose birthday occurs first in the year (month and day) provides primary coverage.
The team at Sunnyvale Dental Care will submit all dental claims for you. Once your primary insurance company pays their portion of your claim it will then be submitted to your secondary insurance company. Many patients with dual coverage who have not reached their annual maximum have little to no out of pocket copay for dental treatment.
Receiving treatment from a GEHA PPO Dental insurance Provider like Sunnyvale Dentist Dr. Gupta will also reduce your out of pocket cost. This is because PPO providers follow the GEHA PPO Dental fee schedule which has fees that are lower than standard dental fees.