5 Reasons You Are Losing Money By NOT Using Your Dental Insurance

Did you know that, unlike health insurance, dental insurance benefits are reset every year on January 1st?

The holiday season is filled with stress and plenty of things to do. One of the most important things that should be on your list is to use ALL of your insurance benefits before they reset. Most insurance companies run off of a yearly reset system where your benefits and limitations reset on January 1st. If you use your insurance a lot, this will be a good thing, but most Americans are WASTING money but not using their full benefits. So here’s a simple strategy to finding out what you need to know along with some good reasons to jump on it ASAP.

  • Call your dental insurance provider and figure out the amount you have left of unused dental benefits. That is also the exact dollar amount you stand to lose if you don’t take the next step and follow through.
  • Call your dentist and make an appointment. The sooner you do this, the more likely your dentist will be able to schedule you or any eligible family member covered by your dental plan before January 1st. While you’re on the phone find out what procedures will qualify.

Typically, cosmetics like whitening and veneers aren’t covered. But preventive procedures such as cleanings, x-rays and routine exams, fillings, crowns, bridgework and other dental procedures up to the amount allowed by your plan. Even if you can’t complete a procedure this year, you can get the procedure started, get a check in or initial look to use up leftover benefits then next year, when your dental plan resets, you can finish the work.

If saving money isn’t a good enough motivator. Routine visits to the dentist can detect early problems like gum diseases and oral cancers. Even a small cavity or leaky filling left unattended can become a bigger, more expensive fix if you ignore it. Fillings are relatively cheap and can be fixed or adjusted but root canal and crowns are big-ticket items and aren’t pleasant to endure

Keep in mind that nothing is getting cheaper either. Inflation is driving up the costs of everything and this includes necessary services like dental procedures. The crown you buy this year could easily cost more next year. Your dentist’s fees might also go up to cover his or her rising costs. A fee increase can also result in a higher co-pay or new insurance fees at the start of a new year. If you are located in the Fremont, CA area, click here to learn more about our clinic.

Still need more convincing? Here is 5 Reasons Why Using Your Dental Insurance Before 2018 is Important.

1. Saving Money

Did you know that by utilizing your dental benefits you could be saving hundreds of dollars per year? While some dental insurance plans run on a fiscal year, most run on a calendar year. Most dental insurance plans are just sitting at the end of the year with benefits unused and go to waste after December 31. Make sure to do it soon so your dentist can get you an appointment as soon as possible.

Dental insurance companies count on making millions of dollars off of patients who never use their entire insurance benefits because unknown to the customer, many of these plans provide coverage up to a certain dollar amount annually. Obviously, insurance companies aren’t going to encourage their customers to use their money, and most patients are too busy to sift through their large policy information. So it’s up to consumers to check to see what benefits they have remaining before the 1st.

2. Dental Problems Worsen, Start Early

Furthermore, addressing dental problems now rather than putting off treatment can prevent the problems from getting worse, which could save you even more money compared to waiting. By delaying dental treatment, you are risking more extensive and expensive treatment down the road. What may be a simple cavity now, could turn into a root canal later. Call your dentist and schedule an appointment to use those benefits.

3. Get Treatment Before New Fees Take Effect or Your Deductible Resets

The deductible is the amount of money that you must pay to your dentist out of pocket before your insurance company will pay for any services. This fee varies from one plan to another and could be higher if you choose an out-of-network dentist. However, the average deductible for a dental insurance plan is usually around $50 per year. Your deductible also starts again when your plan rolls over. Many dental insurances provide little to no coverage until you spend a certain amount out of your own pocket – your annual deductible. If you’ve used your insurance at all this year, you’ve probably made some progress towards meeting that deductible. In fact, you may have already met it completely.

4. Check & Use Up Your Existing FSA Contributions

Another good reason to take care of medical and dental work now is to spend any remaining balance in your flexible spending account (FSA). This is an account that you establish through your employer, and that you may have elected to have some of your pre-tax pay put into. If you don’t use all of your FSA contributions by the end of the year, you lose them.

5. Use up all Annual Maximums

With dental insurance, the annual maximum is the limit on how much the dental insurance plan will pay for your dental work within one full year. This amount varies by insurance company, but the average is around $1,000 per year, per person. The yearly maximum usually renews every year (on January 1 if your plan is on a calendar year). If you have unused benefits, these will not rollover.

Act quickly: You are not the only person who suddenly realized you still had unspent dental benefits. Getting appointments will not be easy but the benefits will be worth it once you realize that you did not waste a dental visit for next year. Give your family and yourself the gift of good oral health this season while making the most of your unused insurance benefits. Contact Serene Dental for appointments in the Fremont area.

Helpful Insurance Terminology

MBA: Maximum benefit available (MBA). The MBA is the most money your dental insurance will pay for root canals, teeth cleanings and other dental work in a calendar year. Whatever you don’t use of the MBA is lost at the end of the year. Think of it as money you paid for that’s sitting in your dental insurance account, waiting to be used by you and only you but it expires January 1st.

EOBs: Explanation of benefits (EOBs). The EOBs are helpful yet sometimes confusing notes your insurance company send out to you that detail how much they’ve paid for your dental expenses each time a dentist submits a claim to them for work you had done. These are usually in a big packet with other information that you SHOULD KEEP. Total up all that your insurance has paid out, as shown in your EOBs. Call your insurance company if you need help and just ask them how much you have remaining on your maximum benefit.

FSA: A Flexible Spending Account (also known as a flexible spending arrangement) is a special account you put money into that you use to pay for certain out-of-pocket health care costs.


About the doctor:

Dr. Sapana Majmudar is one of the top dentist in Fremont, CA. Her clinic, Serene Dental, serves Fremont and the surrounding cities of Newark, Union City, Hayward, Milpitas, Pleasanton, Dublin and San Jose. We have been known for quality dental care and customer satisfaction for more than 20 years. The services include complete family dentistry, orthodontics, cosmetics, pediatric, periodontics, restorative, implants, preventive dental care and much more. Serene Dental is located on Mowry Ave, near 880, next to Wells Fargo Bank in Fremont, CA.

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