For many people, navigating their dental insurance policy can be intimidating because there’s so much fine print. Because of this, they end up only using their monthly investment when it’s an absolute emergency, making them lose money because of unnecessary out-of-pocket costs. If you’re wondering what is important to know about your dental insurance and what’s not, visit your family dentist and discuss your policy. Otherwise, here are four important words and phrases to help you maximize your benefits before they reset on January 1st and any unused ones go back into the pockets of your insurance company.
Annual Deductible
Each year, your insurance provider requires you to pay a set amount of fees out of your own pocket directly to your dentist before they will start picking up the cost of your dental treatments. Once you’ve paid the amount, which is typically around $50, you won’t have to pay it again until your plan renews on January 1st. To get the most out of your benefits, utilize them while you’ve already covered your deductible and aren’t required to cover out-of-pocket fees.
Preventive Dental Care (Checkups & Cleanings)
Most insurance plans reward patients that are proactive about taking care of their oral health by covering the cost of preventive dental care. That’s why the average policy covers two checkups and cleanings throughout the year, which are encouraged to be scheduled six months apart. During these appointments, your family dentist will examine the health of your teeth and gums and treat any small or lingering issues before they have a chance to progress. This examination also includes an oral cancer screening and a thorough professional cleaning to remove any tartar.
Yearly Maximum
Similar to your deductible, your insurance company also provides you with a yearly maximum. This is a capped amount of money that they pay for all of your dental treatments within a 12-month period. The average maximum is between $1,000 and $1,500, which means that any cost of dental treatment you get that’s below this will be lost on January 1st, and any amount over this you’ll need to pay out of your own pocket. To maximize your benefits, it’s best to either meet or exceed your yearly maximum. This way, you can rest assured that you’re not losing hundreds of dollars every year that you could be using on optimizing your oral health.
100-80-50
The average insurance policy covers a higher amount of certain dental treatments because they don’t want patients to wait until the last minute to seek care. This structure is called 100-80-50, meaning they pay for 100 percent of preventive dental care, 80 percent of basic treatments like cavity fillings, and 50 percent of major procedures such as root canal therapy and tooth extractions. Basically, the sooner you get any oral health problems addressed, the less you’ll need to pay out of your own pocket.
On January 1st, your dental insurance policy will restart, meaning that any of your unused benefits will be lost. To get the most out of your investment, it’s important to get all the dental treatments you need before the new year and be sure to use both of your covered checkups and cleanings. If you have any questions about your dental insurance plan or wouldn’t like to navigate your policy on your own, your team of dental professionals will be more than happy to help!
About the Author
Dr. Stephen Langlois has always enjoyed providing entire families with the dental care they need in order to enjoy their natural teeth for a lifetime. He is a member of several professional organizations and has earned the Quintessence Award for his expertise and skills in restorative dentistry. He believes in helping his patients maximize their dental insurance benefits and works with any PPO dental insurance plans. He also offers in-house membership plans so patients can easily take care of their family’s basic preventive care. For questions or to schedule a routine checkups and cleaning, visit Fromuth & Langlois Dental’s website or call 603-644-3368.