Are you making the most of your dental insurance? Recent studies suggest that Americans let thousands of dollars’ worth of dental benefits go to waste every year. While many people don’t fully understand how their insurance plan works, understanding the basics can help you save a substantial amount of time and money while caring for your smile. Read on as your San Diego prosthodontist shares five tips for maximizing your dental insurance.
1.) Know What Your Insurance Policy Covers
The first step towards making the most of your dental insurance benefits is to understand what your policy covers. Most plans follow a 100-80-50 coverage structure, where they will pay for:
- 90-100% of preventive care, like checkups cleanings, screenings, and X-rays.
- 70-80% of basic treatments, including fillings and gum disease treatment.
- 40-50% of major procedures, such as dental crowns and root canal therapy.
2.) Take Full Advantage of Your Checkups
While health insurance aims to help cover the expenses of treating issues once they’ve been detected, dental insurance focuses on helping with the costs of preventing issues from developing in the first place. That’s why nearly every dental insurance policy includes two dental checkups and cleanings every year. The more extensive the dental work, the less your dental insurance company will typically pay for it. So even if your teeth look and feel fine, take full advantage of your preventive care to spot and stop any issues before they progress into larger, more expensive problems.
3.) Don’t Let Your Annual Maximum Go to Waste
Your annual maximum is how much your insurance company will pay for your treatment according to your schedule of coverage once you meet your deductible. In most cases, these benefits don’t roll over when you renew your policy. That means that whatever you don’t use of your annual maximum will expire at the end of the year and your deductible will be reset. If you need dental work and you’ve met your deductible, make sure to schedule your appointment before the end of the year so you can make the most of your benefits.
4.) Plan for Next Year’s Deductible
If you need more extensive dental work towards the end of the year, the costs may exceed what’s left of your annual maximum. In these cases, talk to your dentist about the possibility of splitting your treatment up between this year and next to maximize your dental insurance. This won’t always be an option depending on what type of dental work you need and the urgency of your situation. However, your dentist may be able to schedule part of your treatment to maximize this year’s annual maximum, then schedule the rest for the following year. This way, when you pay for your treatment, the costs will go towards your deductible.
5.) Talk to Your Dentist About Maximizing Your Coverage.
With various types of insurance plans, unique terms, conditions, exclusions, and rules, there’s still a lot more to learn about maximizing your specific dental insurance policy. To make sure you’re making the most of your benefits while caring for your oral health, talk to your dentist. They have plenty of experience navigating dental insurance details and helping their patients save money. They can walk you through what your policy covers and their recommendations for making the most of it.
If you use it properly, dental insurance can save you a significant amount of money! To learn more about about dental insurance or your other payment options, don’t hesitate to give your prosthodontist a call.
About the Author
Dr. Peter F. Johnson of San Diego Denture & Implant Specialists is the most experienced Board-Certified Prosthodontist in San Diego County. He and his team are passionate about repairing broken, worn-down teeth and helping their patients achieve a happy, healthy smile. They are happy to submit pre-determination of benefits and file claims on your behalf to help make your dental care as affordable as possible. To learn more, he can be contacted via his website or at (619) 463-3737.