If you have dental insurance, your insurance company provides you with certain dental benefits each year. In case you’re not very familiar with insurance vocabulary, you can think of an insurance benefit as a dental service that the insurance company pays all or most of the cost of. Most dental plans cover the most common preventive services at 100%, meaning the insurance company pays 100% of the cost & you pay nothing.  But you should know, if you don’t use these benefits each year, they’re gone forever!

Why does it matter whether you use your benefits each year? For one thing, these benefits are provided as a way to help keep you healthy. That’s why preventive & diagnostic services such as exams & x-rays are usually covered at 100% by the insurance company. Even your free cleanings are a great opportunity for the dental hygienist or the dentist to detect potential problems. Think of it as an incentive to get your teeth checked out by the dentist twice per year.

The other advantage of using up your preventive benefits each year is that it can save you money. The healthier you stay & the earlier problems can be uncovered, the less both you & the insurance company will have to pay for more complex care in the future. For example, a cavity that is caught when it’s relatively small & minor will just result in a filling. A big cavity that has gone undetected for a long time until it started causing problems might result in a crown instead, which is a longer, more complex, & more expensive procedure.

Another reason to use up your dental benefits is if you encounter the need for more than one relatively major dental procedure in a single year. If you’ve been told you need a crown, rather than put off the treatment, if you get it done right away you’ll hit your deductible, the minimum you have to pay out-of-pocket before the insurance company starts helping pay for the cost of your care. But say a few months later you end up needing a root canal on a different tooth. If both treatments fall in the same calendar year, you only pay your deductible once. But if the two treatments fall in two different calendar years, you’ll pay your deductible each time. You’ll save money by completing your dental treatment sooner rather than later & using up your dental benefits!

We know dental insurance (or any insurance for that matter) can be confusing. If you have questions about your coverage, we will do our best to answer them. Our staff is trained to make the most of your dental benefits.

As your dental clinic, it’s our responsibility to help guide you through your oral health care so it is as easy & affordable as possible. As a result, we’re dedicated to helping you make the most of your dental insurance, ensuring you get the care you need & you take advantage of every benefit available to you.

Did you know that your dental benefits don’t roll over from year to year? Once you reach the end of the calendar year, your annual dental benefits disappear for good, whether or not you’ve used them.

What do we mean by dental benefits? One of the best examples of a dental insurance benefit are the preventive care services that are usually covered between 80% to 100%, meaning the insurance company pays 80%-100% of the cost of the service . For example, most dental insurance plans give you two teeth cleaning visits each year covered at 100%, meaning you pay nothing out-of-pocket for your dental hygiene visit. Most insurance plans also fully cover at least one set of full mouth x-rays each year.

However, if you’ve visited the dentist for one teeth cleaning this year, that doesn’t mean you get three teeth cleanings next year! Instead, that free cleaning that you skipped goes away at the end of the year & you never get it back!

Another example of your insurance benefits is your annual maximum, meaning the maximum amount that your dental insurance company will pay toward your dental care each year. Annual maximums vary greatly, but say your plan’s maximum is $2,500. If you’ve only used $500 of that $2,500 by the end of the year, the remaining $2,000 disappears & you never get to use it. Essentially, you’re leaving money on the table!

So what should you do if the year is almost up & you still have some of your annual maximum left? Well, this is why the end of the year is a great time to start recommended treatment. First of all, if you haven’t had both your teeth cleanings this year, call us as soon as possible to schedule your second cleaning before the end of the year!

As another example, imagine we told you that you need a crown on one of your molars but you haven’t actually completed the treatment yet. If you continue to put off getting the crown until the beginning of next year, you’ll be throwing away your remaining annual maximum for this year & using up next year’s benefits early instead. That means if you need any other treatment during the course of next year, you will have already used up your annual maximum & will have to pay out-of-pocket for it. Using up this year’s insurance maximum could actually save you money next year by ensuring you don’t hit your maximum too early!

So if you have dental treatment recommendations from us that you haven’t completed yet, give us a call as soon as possible so we can schedule your visit before the end-of-year rush. We’d be happy to help you check to see if you’ve hit your annual maximum yet & help you make the most of the money you have remaining on your insurance plan.