During the hustle and bustle of the holiday season, sitting down to review the terms of your dental benefits plan is probably the furthest thing from your mind. Yet, the end of the year is actually the best time to check if you’ve used every annual maximum benefit available to you. If you forget, you could be leaving money on the table.
At Associated Dentists, we believe in helping families get the most out of their dental coverage. While we strongly encourage pre-planning treatments when possible, we find many of our Madison and Verona-area patients are unaware of the expiration dates placed on annual dental plans. This sometimes makes it more difficult to pay for dental services when dental issues unexpectedly arise at the end of the year, life circumstances change, or if insurance policies are updated with new terms.
In fact, it often isn’t until after the New Year that people realize their deductibles have been reset.
Just under 3 percent of patients with preferred provider organization (PPO) dental plans reach or exceed their plans annual maximum, according to the National Association of Dental Plans. Even if your family uses a Flexible Spending Account (FSA) for dental care with pre-tax dollars, there are annual spending limits you should be aware of.
In fact, most PPO and FSA plans expire on Dec. 31. Miss the deadline — and poof — those unused benefits are gone for good.
What to know about flexible spending accounts
If you have a Flexible Spending Account, you establish how much money you put away each month to cover out-of-pocket healthcare costs, such as co-payments, deductibles, medications, and other health expenses. These pre-tax benefit accounts often work just like a bank account; you can even pay for qualified healthcare services with a debit card.
When it comes to dental care, FSAs typically cover regular dental cleanings, fillings, sealants, as well as a long list of other dental services and procedures offered by Associated Dentists, including teeth bonding, bridgework, crowns, dentures, extractions, gum surgery, and root canals. FSAs do not cover dental care procedures that are cosmetic in nature, such as teeth whitening, veneers or braces.
The general rule of thumb is if you’re in need of any dental services that serve to prevent dental disease, the procedure is likely eligible for FSA coverage.
While most FSA plans expire at the end of the year, similar to PPOs, some plans allow a grace period following a coverage year. This extended period of coverage lasts until March 15 of the next year, so long as there was previous FSA coverage in place before Dec. 31.
If you’re seeking dental services, but simply can’t get in for an appointment due to your busy schedule, talk to your employer or FSA administrator to see if a grace period is an option for you.
Getting the most of your dental benefits
On average, more than 35 percent of Americans skip visits to the dentist’s chair each year. While patients cite things like cost, dental anxiety, and fear of instruments as top reasons for failing to schedule an appointment, patients will pay more down the road if they don’t take preventative care seriously. Further, serious dental problems only exacerbate when appointments are put off — and could even develop into more serious conditions down the line.
When you have access to dental insurance, all it takes is a conversation with your dentist to determine how best to take advantage of your dental benefits.
For example, if you came in for a teeth cleaning over the summer months and a filling was diagnosed, you’ll want to be sure to schedule an appointment before your annual benefits expire. If a more serious procedure requiring multiple appointments is required, you may also be able to apply your benefits toward your first appointment, and schedule your additional benefits under the new year.
Use it — or Lose It!
At Associated Dentists, the last thing we want for our patient families is for their dental benefits to go to waste. That’s why we strongly encourage going over your dental benefits plan before the year is up, placing a call to your insurance provider, or speaking to your employer to determine your account status. If you still have funds and dental care needs to address, you’ll want to schedule a dental appointment as soon as possible.
If you still have questions, or are unsure about what procedures are covered by your dental benefits plan, contact Associated Dentists today. Our dentistry experts can provide you with a path to put your best smile forward.