Navigating any kind of insurance policy causes most people to either immediately stress out or space out. While dental insurance can seem complicated to understand at first, knowing how your plan works and what treatments are and aren’t covered can help save you from having to empty your pockets paying for procedures you need to have. Read on to learn everything you need to know in order to maximize dental insurance benefits while optimizing your oral health.
When Does Your Insurance Plan Expire?
Depending on what type of dental insurance plan you have, it may run on a fiscal year or a traditional calendar year. Most people who have private dental insurance have benefits that expire at the end of the calendar year, which means that yours will most likely renew on January 1st. When this happens, any benefits that you haven’t used will be lost, and you’ll need to repay your fees, like your deductible, before your provider will start paying for the cost of your treatments.
What Dental Services Does Your Plan Cover?
The best way to learn what specific dental treatments that your plan will cover is to contact them directly and ask. Otherwise, most companies use a 100-80-50 structure. All that means is that they pay for 100 percent of the cost of preventive dental care (including your two covered checkups and cleanings annually), 80 percent of all basic treatments like fillings, and 50 percent of major treatments like root canals and tooth extractions.
Have You Taken Advantage of Your Checkups and Cleanings?
Dental plans usually include two checkups and cleanings that are completely covered every year. That’s because they encourage patients to be proactive about their oral health so they can avoid needing invasive and extensive treatments.
When you visit your dentist for a checkup and cleaning, they’ll examine your mouth in search of any developing oral health problems like cavities. This allows them to catch and treat the issues before they turn into something more severe, causing you severe pain and discomfort. They’ll then professionally clean your teeth and remove any tartar, keeping additional damage from occurring. Since two semi-annual visits are already covered, it’s best to take advantage of them to keep your oral health on track and avoid hefty out-of-pocket costs from serious procedures.
Will You Meet or Exceed Your Annual Maximum?
Insurance companies usually place a cap on the amount of services that they’ll pay for during the year, called the maximum. The average amount is between 1,000 and 1,500 dollars, meaning that any remaining balance that hasn’t been used by January 1st will fall back into the pockets of your insurance provider. In order to maximize your benefits, be sure to meet or exceed your annual capped amount and get all the dental treatments you need before it resets.
With the right dental team by your side, you’ll have help maximizing your benefits and getting the most out of your monthly investment in insurance. They’ll also make sure your oral health remains in tip-top shape while saving you from unnecessary out-of-pocket costs.
About the Author
Dr. Chris Combs has over two decades of experience as a dentist and takes great pride in providing his patients with honest and high-quality care. He makes sure that his team does everything they can to help patients maximize their dental insurance benefits and save money. He’s also an in-network dentist with BlueCross BlueShield, Delta Dental, and Cigna, and accepts insurance that he isn’t an in-network provider with. For questions or to schedule a routine checkup and cleaning before your benefits restart on January 1st, visit Combs & Associates Family Dentistry’s website or call 479-488-6131.