As the year comes to a close, it’s important to make sure you’re getting the most out of your insurance benefits. Many plans operate on a calendar year, meaning your unused benefits will not roll over into the new year. But with a little planning, you can maximize your dental insurance and take full advantage of the coverage you’ve been paying for.
What Does Dental Insurance Cover?
Understanding your coverage is key to getting the most out of your dental insurance. While plans vary, most policies cover preventive care like oral cancer screenings, cleanings, exams, and routine x-rays at little to no cost.
Most plans also offer at least partial coverage for restorative treatments like fillings, crowns, dentures, and even implants. Although the amount covered will depend on your specific policy, most dental insurance policies have a 100-80-50 structure:
- 100% coverage for preventative care such as exams, cleanings, and x-rays.
- 80% coverage for basic care such as fillings and extractions.
- 50% coverage for major care such as crowns, root canals, and dentures.
Before the year ends, check your insurance policy to see what it covers. You might be surprised to learn that some treatments you’ve been considering are covered more than you think!
How to Get the Most Out of Your Dental Insurance
Schedule Preventive Care Appointments
Dental insurance typically covers preventive care because it is essential for maintaining a healthy smile. If you haven’t already scheduled your second routine cleaning this year, now is the time. Dental cleanings not only brighten your teeth, they also give your dentist a chance to spot the early signs of problems, preventing the need for more costly treatments later on.
Take Advantage of Your Annual Maximum
Many dental insurance plans have an annual maximum, which is the most your insurance will pay toward your dental care in a year. If you have any pending dental work—such as fillings, crowns, or implants—now is a great time to use those benefits before your annual maximum resets. Keep in mind that most dental offices get very busy towards the end of the year, so book your appointments early!
Combine Treatments
If you need multiple procedures, talk to your dentist about how they can combine treatments into fewer appointments. Most insurance plans cover a portion of each treatment up to an annual maximum, so getting more procedures done at once will reduce your total appointments and help you use all of your insurance coverage.
However, it’s important to note that if you’ve already reached your annual maximum, your insurance will not cover further treatments until the next benefit year. This means that any additional costs would need to be paid out of pocket.
If you have insurance with a deductible instead of an annual maximum, check to see if you’re close to meeting your deductible for the year. You may be able to get additional treatments that are fully covered by your insurance. By combining treatments now, you won’t have to pay any out-of-pocket costs again until next year.
Split Up Major Treatments
If you’ve been putting off major procedures like full mouth rehabilitation, or dental implants, now is the time to consider scheduling them. Some treatments may take multiple appointments, and starting before the end of the year can allow you to maximize this year’s benefits and roll into next year’s coverage for any follow-up care. This is an excellent way to spread the cost of major treatments over two insurance periods, helping you save more in the long run.
Use Your Flexible Spending Account (FSA)
If your insurance plan includes an FSA, make sure to use any remaining funds before the end of the year. Not all FSA money can roll over into the new year, so it’s better to apply it toward dental treatments while you still can. If you need a crown, implant, or dentures, using your FSA can significantly reduce your out-of-pocket costs.
Don’t Let Your Benefits Go to Waste
The end of the year is fast approaching, and so is the expiration date for your dental insurance benefits. If you’re unsure what your insurance covers, our team at Baker Dental will be happy to help you navigate your benefits so you can get the most out of your coverage.
But remember: year-end appointments fill up quickly! Contact Baker Dental today to schedule your appointments and make sure you’re making the most of your dental coverage. Whether you need preventative care, basic services, or major care, we’ll help you start the new year with a bright, healthy smile!
Images used under creative commons license – commercial use (11/18/24). Photo by Marek Studzinksi on Unsplash.