It is easy to understand why many people aren’t sure what their dental insurance benefits cover or how to make the best use of them.
The final few months of the year are a good time to take a look at your available benefits and make a plan for any dental care you may need.
Deductibles vs. Annual Maximums
Two terms are often confused:
- A deductible is the amount you are responsible for paying toward certain covered dental services, before your insurance plan begins contributing.
- An annual maximum is the most your dental benefit plan will pay toward covered dental care during a benefit year.
Let’s say your plan has a $50 deductible and a $1,500 annual maximum. The deductible is an amount you may need to pay before certain benefits begin, while the $1,500 maximum is the most the insurance plan will pay during that benefit year.
Most traditional dental plans do not carry unused annual maximum benefits into the next year. When the new benefit year begins, the available maximum generally resets.
If you already have treatment that has been diagnosed or have been putting off an examination, fall is a good time to find out what may need attention and what benefits are still available.
Insurance Doesn’t Cover Everything
Your dentist—not your insurance company—determines recommended treatment, based upon your dental health and needs. Your dental benefit plan determines what services it will contribute toward and how much it will pay.
A recommended treatment may not be covered by a particular plan. That doesn’t mean the treatment isn’t needed; it simply means the treatment falls outside of what that benefit plan has agreed to pay for.
Your dental office can help explain treatment options and provide estimates of what your plan is expected to contribute; but your benefits are determined by the plan selected by you/your employer and the insurance company.
FSA/HSA Dollars
Flexible Spending Account (FSA) funds may be available for eligible dental expenses. Many FSA plans have year-end deadlines; it is worth checking your individual plan.
Health Savings Account (HSA) funds generally remain in your account from year to year. Eligible dental expenses can usually be paid with HSA funds.
Oct.—The Time to Act
Dental offices receive a rush of calls in Nov. and Dec., from patients hoping to complete treatment before benefits expire. There are only so many appointment times available, and some dental treatments require more than one visit or time between appointments.
If you haven’t had your routine dental examination, have treatment you’ve been meaning to schedule, or simply aren’t sure what your dental benefits look like for the remainder of the year, now is a good time to check.
A little planning now can make the end of the year much easier.
Dr. Tiffany and her dedicated team at Bellbrook Dental are always happy to help you navigate your dental benefits, answer your insurance questions and understand your treatment options, so you can make the best decisions for your dental health. Contact us at bellbrookdental.com or 937-848-8662.
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