Double dental insurance question

[vafoodie]

When we retired, we lost our dental insurance, so I purchased a insurance plan at my dentist. Since then my husband has gotten us dental insurance as part of our new market insurance plan. I called my dentist office where I purchased the insurance and I cannot get extra cleanings with the second insurance policy. That would be fraud. Is it fraudulent to use the new
insurance at another practice to get additional cleanings? Anyone find themself in this position?

 

[pacergal]

Are they are different insurance companies? If so, I don't think that would qualify as fraud, but I am not a lawyer.
Do your teeth need more than 2 cleanings a year?

We had double insurance one year, but same company. So the only way we could use both, was to hit the limit on one first, then the other kicked in. But no-one had any dental emergencies, or excessive work needed that year, so it didn't make any difference.

 

[brett]

When I submit a HSA claim with our insurer one of the questions is 'are you or your spouse/partner covered by another health care plan'?

Do not know what happens if you say yes. I assume the question relates to two people who are both covered by different employer plans.

 

[JoeWras]

Well yeah, insurance always has "coordination of benefits" when two ore more are involved.

The problem here is medical necessity. Most of the time, 2x per year is fine. I could see that if your dentist could prove necessity for more than 2x per year, then the secondary carrier would cover the extra cleaning. But the dentist is going to have to tell a story on why it is required otherwise the insurance will reject it.

Fraud? Not when insurance knows everything (and they do). They just reject it.

Perhaps the fraud comes in place if the dentist says it is necessary but has no good reason to say so. And that makes sense because something like this is rarely necessary.