If you are like most patients, you may not know the ins and outs of your dental insurance plan. Do you know your exact coverage? Do you know your deductible or annual maximum? Most importantly, do you realize that your dental benefits expire at the end of each year?
Many of us understand the advantages of having dental insurance to help cover the costs of oral health care. However, few patients fully maximize their insurance benefits to make the most of their plans.
Here, we will explain the perks of dental insurance, how most plans work, and how to maximize your dental benefits now and in the future.
What Is Dental Insurance?
As mentioned above, dental insurance is a plan to help pay for your dental health needs. While separate from medical insurance, dental plans may be bundled in an employer’s benefits package. It may also be purchased for individuals and families through the healthcare marketplace. The type of plan, coverages, and waiting periods vary from company to company.
You Paid for It, Now Use Your Benefits
Dental insurance isn’t free. Someone, you or your employer, pays for it. However, once paid for, the benefits exist and should be used to ensure you get your money’s worth. To better understand your plan and your coverage, you must first understand the terminology.
As with health insurance, to even have a dental insurance plan, you must pay a monthly, quarterly, or yearly fee. This is called a premium. Your premium is the amount you are charged to maintain your insurance benefits. This does not include your copay, deductible, or other fees. This is simply the cost to have coverage for dental care.
Your deductible is a set amount that you must pay out-of-pocket for dental treatments before your insurance company contributes to the cost of services. This means you pay your dental practice directly for services first until the deductible is met. Usually, preventative care is fully covered from the start and does not count toward your deductible.
Your annual maximum is the highest amount the insurance company will pay for services in a given year. This is the portion the plan pays on your behalf and does not apply to or include the deductible or copay. The yearly maximum resets each year and does not roll over.
This means the unused portion that the insurance company has set aside for your dental needs will disappear if you don’t use it.
Use Your Insurance Benefits Before the Year Ends
Now that you understand how the fees and coverages work, it’s time to plan how to use your dental benefits plan to make the most of it. Let us help you keep your mouth healthy while maximizing your dental health plan.
Keep Your Smile Healthy with Preventative Care
As mentioned, preventative services are often fully covered without needing to first meet your deductible. This is because prevention is often the best treatment method and is less expensive than restorative procedures to correct problems.
Routine dental care, such as exams and cleanings, are considered preventative treatments. Appointments are scheduled every six months to remove plaque and tartar, keep the gums healthy, and to prevent or catch problems before they escalate.
Skipping these appointments can be costly. Not only do you lose out on your prepaid coverage, but also you risk allowing a minor issue to erupt into a more serious (and more expensive) fix. Keep your dental appointments to make the most of your preventative care and protect your oral health.
Get Smaller Restorative Procedures
Restorative dentistry ranges from minor, such as fillings, to major, such as crowns, bridges, or dental implants. As such, insurance companies only cover a percentage of these treatments or a certain number of treatments per year. Generally, minor restorative procedures are covered at a higher percentage than major restorations.
Many plans follow a 100/80/50 structure. This means preventative care is covered at 100%, minor procedures at 80%, and major treatments at 50%.
This cost breakdown of minor versus major treatments is another reason routine care is crucial. It saves money from your own pocket. If you need a filling, treat it early. This saves you from needing a more extensive and more expensive root canal or extraction plus a restoration later.
Plan for Extensive Dental Work
Insurance plans can be confusing. Our team works with you to help you understand the terminology and your plan’s benefits. We help you make the most of your coverage to maximize your benefits, save you money, and protect your oral health.
If your plan has a high deductible, your annual maximum has been reached, or a specified number of treatments are covered yearly, we work with you. We can customize your treatment plan to space restorative treatments accordingly to ensure your oral health needs are met and you make the most of your dental insurance benefits.
Maximize Your Dental Benefits Before They Expire with Aten & Garofalo Dentistry
Understanding your dental benefits doesn’t have to be daunting. Let the team at Aten & Garofalo help you maximize your benefits before they expire. We offer a wide range of dental services in Ballantyne Charlotte, NC. We provide dental care in a warm, welcoming environment so all patients feel comfortable and confident in their smiles.
Contact us today to schedule an appointment before your plan runs out at the end of the year.