Did you know that you could actually save hundreds of dollars by using your dental benefits before the end of the year? In fact, putting off needed dental work can backfire due to not only the financial impact but also an escalation of negative health conditions.
Less than half of insured adults actually use their dental benefits even though most participate in employer-sponsored dental insurance plans. Less than 5 percent of those insured maximize their dental benefits every year, and when you don’t use your benefits, you lose them.
Whether you’re paying for dental care through a benefits plan or using a flexible spending account, your current plan will most likely run out on December 31. Don’t let your hard-earned dental dollars go to waste. Here is a breakdown of what these benefits are and how to make the most of your insurance.
Types of Insurance Plans
Flexible Spending Accounts
A Flexible Spending Account (FSA) is an account you can set up through your employer. During open enrollment, you choose how much money to put into this account, and a portion of this amount is deducted from each paycheck pre-tax. FSAs generally cover services or products that help keep your mouth healthy, including cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures, and more.
Many FSAs work like debit cards, and you can use that card to pay for various medical and dental expenses, including some products available at your local drugstore.
Some provide a grace period of up to 2½ extra months to use the money in your FSA.
Others may allow you to carry over up to $500 per year to use in the following year.
Health Savings Accounts
Health Savings Accounts (HSAs) are only for patients who have a high-deductible health plan. They are a supplement to cover expenses that your regular health plan doesn’t cover. Think of your HSA as a medical IRA, which can build up as you save and make contributions.
Money is deposited into the account before your paycheck is taxed, so it’s as though you are paying for your out-of-pocket medical costs tax-free. HSAs earn interest, just like a bank account — and typically at higher rates.
When you need to use your benefits, you usually have a debit card to pay for the expenses outright. Alternatively, you can allow your HSA to keep earning tax-free interest and simply send your receipts to be reimbursed at a later date.
HSAs cover most dental work and are great for regular expenses such as copays, deductibles, and medications. They are usually independent of your employment.
Typical Coverage of Most Dental Plans
- Preventive care: periodic exams, X-rays and, for some age groups, sealants — 100 percent.
- Basic procedures: office visits, extractions, fillings, root canals (sometimes) and periodontal treatment — 70 percent to 80 percent.
- Major procedures: crowns, bridges, inlays, dentures, and sometimes implants and root canals — 50 percent or less.
Orthodontics coverage usually can be purchased as a rider, and cosmetic care isn’t covered.
5 Reasons to Use Your Dental Benefits Now
1. Yearly Maximum
Your yearly maximum is the most amount of money that your dental insurance plan will pay out for dental work during the year. Maximum payouts vary between insurance companies and plans, but most range from $1,000 to $1,500 per person, per year for restorative procedures. This maximum renews at the beginning of the year, and unused benefits typically won’t roll over.
2. Deductibles
The deductible is the amount you pay out of pocket before your insurance company will pony up and pay for any services. Dental plan deductibles are typically much lower than regular health insurance deductibles, with most only needing you to pay of $50–100 before they start paying for dental work. Since your deductible will reset with the new year, getting your dental work in now rather than next year will save you money!
3. “Free” Preventive Care
Since you’re already paying your premiums, don’t let that investment go to waste by missing out on “free” benefits of your plan. Great hygiene and early intervention are the best way to avoid expensive dental procedures down the road, so most benefit plans cover 100 percent of preventive care visits for things like exams, X-rays, and cleanings, ignoring deductibles altogether. Even if you don’t think you need any restorative work, you should take advantage of dental checkups that you’ve already paid for before the opportunity fades with the year’s end.
4. Fee Increases/Changes to Benefits
Dental benefits don’t usually get better with time. Year over year, the costs tend to increase and insurance companies attempt to cover less and less. Getting your needed dental work in now takes advantage of your current and probably best deal. If you wait, when you finally do schedule that needed dental work you might have to contend with increased premiums, copays, or fees.
5. Dental Health Can Worsen
Prevention is the name of the dental game. Is a toothache causing you problems? Waiting can turn that simple cavity into a root canal down the road. Delaying treatment of a needed crown (for example) can lead to more extensive and expensive treatment later. When you ignore dental issues and give them time to develop, they end up becoming much worse than whatever the original problem was.
Does My Plan cover All Dental Work?
Routine dental work, such as crowns, bonds, or dentures, is typically covered. Do your children need sealants or cleanings? Those are covered, too. Cosmetic procedures, such as whitening or veneers, may not be, but you should check your plan to be sure.
Many people forget to book dental appointments and then have to scramble to take advantage of their benefits before the year ends. We’ve almost run out the clock on 2019, so schedule an appointment at our Bedford dental practice right away so we can see you as soon as possible.
~Dr. Marea White