Some dental insurance policies reset at the end of the year, meaning you will lose benefits you’ve earned by paying your monthly premiums. The good news is that you still have time to schedule a dental appointment to take advantage of the compassionate care that you are entitled to.
Whether you have a Flexible Spending Account, a Health Savings Account, or a dental plan with a deductible, it’s important to understand whether your benefits roll into the new year. While some renew at the beginning of the year, others do on an enrollment date or the fiscal year.
How Does Dental Insurance Work?
Dental insurance policies help people to budget for the cost of maintaining their smile and their oral health. It may be a part of your existing medical insurance or a standalone policy. When you first start a new insurance policy, you may have a waiting period before any major work can be done.
You will pay a deductible which is the minimum amount that must be paid before insurance pays anything. After that time, a copay may also still be required. When you meet this deductible, your policy will cover a percentage of the cost. The types of dental procedures covered by dental policies are generally categorized as basic, preventive, and major. Most dental insurance covers 100% of preventive care.
What is a Flexible Spending Account (FSA)?
Flexible spending accounts help save money as they allow you to contribute to them with pre-tax money and use it on dental procedures. This can yield up to 30-40% savings from your pocket. While yes, you may get two cleanings under your dental insurance policy, you must pay a deductible out of pocket or a percentage of the cost that isn’t covered.
Medically necessary procedures can use FSA funds. Elective cosmetic procedures such as veneers or teeth whitening cannot use FSA funding. While an FSA is a great tool for saving money, some have a “use it or lose it” rule. It’s always good to understand your dental insurance benefits so you can maximize what you benefit from them.
What is a Health Savings Account (HSA)?
Health savings accounts are a great way for you to reserve funds for any healthcare costs for the year. This may include prescriptions, co-payments, or hospital bills, to name a few. They can also be used to pay for dental care. While dental insurance generally covers these costs, an HSA can help pay for any out-of-pocket expenses you may incur from dental procedures.
However, there are some eligibility requirements for what is covered in your HSA. The IRS says that qualifying medical expenses from your HSA include anything that is medically necessary, whether procedures, products, or medications. They must be used to treat or prevent specific dental issues such as gum disease or tooth decay.
Dental Procedures That a HSA Can Cover
Your HSA can help you pay for many different dental services or orthodontic procedures. Some dental procedures that you can use a HSA for include:
- Fillings
- Crowns
- X-rays
- Braces
- Prescription medication
- Dentures
- Dental Implants
- Tooth sealants for kids
Floss, toothbrushes, mouthwash, denture maintenance items, or teeth whitening are all ineligible things to use for HSA funds. These are general-use expenses as they relate to dental maintenance and not a specific dental issue or concern.
Using Your Dental Insurance Benefits
Yes, it’s important to use up your dental insurance benefits, but don’t wait till December to schedule your dental exam. Many other patients are also trying to use up their plan benefits, so the sooner you can call and make an appointment, the better. This is especially true if you’re overdue for preventative procedures such as dental cleanings or if you need to replace old fillings to prevent decay beneath them.
Benefits of Scheduling Dental Treatments Before The End of the Year
Whether you’re using traditional dental insurance or an FSA or HSA account, here are some advantages of scheduling dental appointments before year-end. While the holidays and the new year is always an exciting time, it is important that you have the chance to use up your insurance benefits beforehand.
Policy Changes
It’s not uncommon for dental insurance providers to change their policies each year. This may mean an adjustment in how much they will cover for certain services, how much your premium will be, or, if you’re shopping for new insurance, a waiting period before you’re eligible for certain dental treatments. It’s always best to use your current insurance policy fully before you lose it.
Extensive Procedures
When you wait to have important dental appointments, you may require even more extensive procedures. For example, if you allow tooth decay or gum disease to advance, you may need more advanced treatment that is more costly. Using your insurance benefits ensures that you use all of your funding, but also you ensure your oral health is always at its best.
Most PPO insurance plans allow you to have two preventive appointments annually. These visits are usually covered 100%. If you haven’t had your second checkup of 2023 yet, it’s time to schedule it before December 31st.
Split Up A Treatment Plan
If you need a major treatment that may exceed your insurance maximum, you may be able to split it up across appointments and calendar years. This allows you to use this year’s and next year’s benefits.
Save Money From Increased Rates
Dental offices have some of the largest overheads of any industry. This means that the cost of dental services and procedures frequently increases yearly. It may cost less one year and increase the next.
Schedule A Dental Appointment To Use Up Your 2023 Dental Insurance Benefits
Are you getting the most out of your dental insurance benefits for 2023? Time is running out, so visiting your general dentist as soon as possible is important when you want to use every last dollar up. Not only will your budget thank you, but your smile too.
By planning ahead and scheduling your last dental appointments for the year, you beat the end-of-the-year rush. You can already be on the books and ready to use up all of your insurance benefits. Call our Boynton Beach dental office at 561-733-4004 to help you determine which benefits are still available to you this year. Our staff can help you determine which treatments will be covered by your current plan.