Aten & Garofalo Dentistry

Use Your Dental Benefits Before the End of 2023 or Lose Them!

Home > Use Your Dental Benefits Before the End of 2023 or Lose Them!

Use Your Dental Benefits Before the End of 2023 or Lose Them!

Schedule an exam in Ballantyne near Charlotte, NC to use your dental insurance benefits before they expire

It’s that time of year again. The holidays are upon us and everyone’s busy dashing from one celebration to another. But something you might not be thinking about is your dental insurance benefits expiring. It’s easy to forget about the dental benefits you’ve paid for, especially when they’re not something you can touch and see.  

Nonetheless, not using your benefits before the calendar year ends means they can go to waste. Knowing what dental insurance benefits you can use with your Ballantyne dentist near Charlotte, NC helps avoid this. If you don’t know anything about how to get the maximum benefits from your dental insurance, it’s OK!

Our dentists in Ballantyne, Dr. Aten and Dr. Garofalo, share everything you need to know about your dental insurance benefits. Read on to discover the basics of dental benefits and how to get the most out of them.

Dental Insurance Benefits 101

You probably already know your dental benefits are separate from your regular health insurance. But you may not know everything your dental insurance benefits cover or how they work. First, let’s look at what dental insurance plans typically cover and some of the differences between plans. 

1. What’s Included In the Benefits of Dental Insurance

The benefits of dental insurance plans will vary, but they typically cover preventative care. Under the preventative care umbrella are semi-annual dental exams, routine cleanings, and annual X-rays. Dental insurance plans also typically cover some of the cost of crowns, fillings, tooth extractions, and root canals. 

Some plans will include more advanced treatments, such as orthodontics and dentures. The majority of plans operate under what’s known as the 100-80-50 structure. What does this mean? Here’s a breakdown for you.

  • The plan pays for 100% of your preventative care, such as X-rays and routine cleanings.
  • The plan pays for 80% of your basic procedures, such as fillings for mild to moderate cavities.
  • The plan pays 50% of your major procedures, such as bridges and implants

2. Differences Between Plans 

You’ll want to read the fine print of your dental insurance plan since the types of covered treatments can vary. For instance, some insurance plans do not cover dental sealants. Others may cover a portion of the cost for major restorative procedures but have a one-year waiting period.

At the same time, what percentage of your treatments your plan pays can differ based on the plan type. Preferred provider organization and dental health maintenance organization plans have in-network versus out-of-network providers. If you visit an in-network dentist in Ballantyne your out-of-pocket costs will be lower. Those costs will be higher with out-of-network providers.

There are also what’s known as discount and referral dental plans. With these plans, your Ballantyne dentist near Charlotte may give you a discount on treatments. Discount plans do not include traditional dental insurance benefits. Plus, these plans usually work with a select group of providers.

Getting the Maximum Benefits From Your Dental Insurance

To get the maximum dental benefits from your dental insurance, it helps to know your plan’s stipulations. Besides waiting periods, some plans require your dentist to get pre-authorizations. A pre-authorization includes a treatment plan you and your dentist have discussed. 

The insurance provider checks the treatment plan and determines whether those treatments are eligible for coverage under your dental benefits. Say you visit our dentist in Ballantyne near Charlotte, NC. We determine you need two fillings and can complete the procedures before the year ends. More than likely, there won’t be a problem getting approval within the same calendar year.

However, problems can arise when preauthorizations and treatments don’t occur in the same calendar year. Many plans restrict how many procedures are covered in a single calendar year. Others will limit how much they’ll pay annually. This is why it’s important to check your plan’s fine print for annual maximums and the allowances under each type of treatment. 

How To Verify Your Dental Insurance Benefits

Wondering how you can verify your dental insurance benefits? There are a few ways to go about it. First, you can do the legwork yourself by calling the number located on the back of your dental insurance or dental benefits card. 

You’ll want to let them know the type of treatment you’re seeking. Also, give them the information about which dentist in the Ballantyne area you’re thinking of going to. If you don’t want to spend time on the phone, many insurance plans offer self-service portals online.

With these portals and tools, you can sign in and check what your plan covers. You can also search for in-network dental practices. Furthermore, you can see how much of your benefits you’ve already used and how much you have left before they expire.

But your dentists in Ballantyne near Charlotte, NC will do the legwork for you. The dental practice will verify your dental insurance benefits before your next visit. For emergency or urgent treatment, the practice can usually verify your coverage on the spot during business hours. Be sure to bring an up-to-date benefits card, even if it’s a digital one. Write down the insurance carrier, your group ID number, and your member number if you’ve recently changed plans. 

How To Estimate Your Dental Insurance Benefits

In most cases, your dentist will help you estimate your dental insurance benefits. The practice will calculate your out-of-pocket costs, if any. Your dentist will also tell you what your dental benefits under your plan will cover. 

Your estimate for various treatments will depend on the structure of your benefits and whether you have an annual deductible. Your deductible is an out-of-pocket expense you must meet each year before your benefits kick in for treatments that aren’t covered at 100%. 

Suppose your annual deductible is $500. Your dentist determines you need $1,000 worth of restorative procedures. You’ll pay your $500 deductible before the remaining cost is covered according to your plan’s structure. Some plans will also only cover what’s known as “downgraded” procedures. For example, you may pay more out-of-pocket for a composite versus an amalgam filling.  

Use Your Benefits With the Best Dentist in Ballantyne Near Charlotte, NC

Our dental practice in Ballantyne near Charlotte helps coordinate your dental benefits

Before the new year begins, it’s important to get the maximum benefits from your dental insurance plan. Don’t put off your cleanings or the fillings you need! Use your dental insurance benefits at our dental practice in Ballantyne near Charlotte, NC before you lose them. 

You’ll be taking an important step toward making sure your oral health is on track! Contact us to book an appointment for your next exam or dental procedure. We’re among the top dentists in the Ballantyne area and put our patients’ needs first.

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