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Get the Most Out of YOUR Dental Benefits

November 19, 2015 No Comments


With all of the changes that have been made to health care and dental care coverage over the last year, we thought it was important to cover some of the basics of dental benefits and insurance. We receive questions about dental benefits and coverage often. We know how important it is for you to understand your dental insurance plan, and we are happy to help clarify some things. Below are some questions regarding the dental insurance and benefits; we hope this will help you navigate the somewhat-confusing world of dental insurance.

Do my dental benefits roll over from year to year?

Because dental insurance benefits renew each year, you will not likely be able to roll over your unused benefits from the prior year. It is important that you make sure to schedule your cleanings and exams twice a year to avoid missing out on the advantages that your plan offers you. By scheduling your regular checkups, any problems can be addressed and treated before it becomes a bigger problem (i.e., a higher dental bill).

How can I maximize my dental benefits before the year is over?

Almost all of the insurance companies have annual maximums that they do not exceed. What this means is that there is a total maximum amount that your insurance will pay each year. Once you reach that maximum, you are responsible for any remaining balance. If you have not reached your annual maximum and need dental treatment, it is important to do this before the end of the year (when benefits usually renew).

If you are planning extensive treatment, you can plan the treatments in stages. For instance, you can have your first treatment done and then wait for your plan to renew before having your second treatment if you are close to meeting your maximum. As previously mentioned, if you have enough benefits remaining before the end of the year, it is wise to use those as they will not roll over to the new year.

Another way you can maximize your dental benefits is to make sure to get your cleanings and exams done at least twice a year. Most dental insurance providers cover 100% of preventative care (Cleaning, X-Rays, and Exams) two times a year. If you are not taking advantage of these benefits, you are not maximizing your dental coverage to the fullest.

What are some of the procedures that will use my dental benefits?

Again, most dental insurance plans cover 100% of preventative care. This means that your cleanings, exams and X-Rays are covered twice a year. There are basic dental procedures for certain problems, such as needing an extraction, fillings, root canals, and treatment for gum disease that the insurance will pay. However, you will likely be responsible for paying a portion of the bill. This is what is known as your co-payment. Typically, 70-80% of these expenses are paid by your insurance carrier. Major procedures, including crowns, bridges, inlays and dentures, are usually covered at 50% coinsurance.

Since we are coming up on the end of another year, it is important to make any necessary appointments before the renewal date. This time of year is usually busy, and we want to make sure you get the treatments you have earned before your insurance renews! For more information or to schedule an appointment, contact us here!