Dental Benefits: Use Them or Lose Them
According to the National Association of Dental Plans less than 3% of those with PPO dental coverage reach or exceed their annual plan maximum. Any remaining dental benefits are forfeited at the end of each benefit year because patients either do not understand their dental coverage or are not scheduling appointments due to a variety of reasons. In addition to dental insurance, some people have pre-tax dollars in the form of Flexible Spending Accounts (FSA) they can use for dental treatment.
Most of these plans and FSAs expire on December 31. Do not let those hard-earned dollars go to waste, as almost none of them roll-over to the next year. Use them or lose them.
How to Make the Most of Your Plan
Utilize your Preventative Service Benefits to their maximum allowance. As they say “an ounce of prevention is worth than a pound of cure”. Since most plans cover 100% of preventative care visits, it may not cost you anything but time. So, schedule yourself a cleaning and check-up to prevent more serious and costly dental problems.
Use your coverage early and plan ahead. Yes, your schedule is busy and hectic, but there may be times of the year that are more convenient than others to schedule an appointment. Summer, spring break, Teacher-in-Service Days and winter break are perfect times for teachers and students to get their mouth healthy. Many banking and federal holidays are not typical days off for dental offices. If you work in one of these fields, ask about scheduling appointments on those days. Waiting until November or December to schedule major dental treatment can be problematic if you must also see other dental specialists or have dental labs fabricate crowns or dentures. As already mentioned, most plans cover you through December 31st. So, if your favorite dental office is closed between Christmas Eve and New Year’s Day, you might not get that crown you have been waiting all year to get. Plan ahead.
Once you have determined your treatment needs, ask for a pre-authorization. Pre-auths give subscribers estimates of what is covered and if there are any restrictions or waiting periods. These out of pocket estimates help you budget accordingly and determine how much money you need to put into your Flexible Spending Account (FSA).
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, fillings, crowns, dentures and more.
If you have dental needs that you know will exceed your insurance benefits plan ahead and get an estimate of your out of pocket expenses. The estimate can help you figure out how much to deduct each pay period. If you need help determining your dental needs and costs associated with making your teeth healthy, please do not hesitate to give our office a call. We can help you make the most of your benefits and help you understand them better.
