Are you getting all the value you should be from your dental insurance policy? Learning the details of your dental coverage is more than worth the effort. It’s important to your health, both physically and financially. Consult with your employer, insurance broker, the insurance provider itself, and use government resources to learn more about your dental insurance.
While every policy varies, many of the same key parameters are present in most policies. In general, benefit schedules are measured in years. You might, for example, be eligible for two check-ups each year. More complex procedures, on the other hand, may be available once during a two- or three-year period. Learning your dental insurance benefits allows you to get the most value out of your payments, and helps you plan necessary care properly.
Responsibility: You, Your Dentist, and Your Dental Plan
Your responsibility is to know your policy. Your oral health is your dentist’s primary responsibility. Their first job is to tell you the treatment you need based on healthcare concerns. And when treatment beyond regular cleanings is deemed necessary, your dentist will also assist by filling out the pre-treatment and claim forms required by your insurance company before payment will be issued.
But if you haven’t done your homework, it’s possible that you may find out that your insurance doesn’t cover the procedure, or that you need to wait for a certain date to pass (usually the end of the calendar year) before it will be covered. Waiting for treatment is never ideal, but may be necessary in these sorts of cases. At Loreen Wong we work hard to keep the lines of communication open with our patients, and will do our best to help you plan ahead for what may be extensive procedures.
The Importance Using Your Benefits Each Year
It may seem counter-intuitive at first glance, but you can actually save money by using up the benefits in your dental plan each year. In addition, your policy’s treatment schedule may make it more practical to have a procedure done before the end of the current year, rather than after the start of the next year. All policies are different, but there are commonalities that show why using your benefits each year is the right choice.
- Yearly Maximum – Your yearly maximum is the total amount of dental work your policy covers in a year. This amount resets every year and benefits don’t roll over, so use them up while you have them.
- Coverage Percentage – Plans vary in the percentage of procedures covered, with the most common amounts being 50%, 80% and 100%. What is not covered is referred to as the “patient portion”.
- Fee Increases and Premium Costs – You may find that getting a procedure at the beginning of a new year is more expensive than it would have been at the end of the prior year. You’ll also be paying your premiums either way, so you may as well use the benefits. Even if your oral health is strong, your plan still provides for regular checkups and cleanings.
- Fee Guides –Even if you have 100% coverage it’s possible you may still have to pay a patient portion of the procedure amount. Often insurance companies use outdated fee guides, and so when costs change,100% of the fee guide they are using is not 100% of the dental office’s fee guide.
- Your Oral Health – Using your insurance benefits is also a great way to improve your quality of life. Oral health issues are often uncomfortable at best, and very painful at worst. Why wait to get something fixed if you don’t have to? Even if your symptoms aren’t severe, dealing with an oral health issue in its early stages is the best way to avoid future complications.
Using your insurance benefits each year is simply the smartest decision. Just remember to check your individual policy for details. Your policy may reset on January 1 each year, or it may reset based on the date the policy was activated. The benefits you’re entitled to also vary by policy. Learn your policy’s details to save money and keep your oral health strong.
Dental procedures have come a long way since the days of the barber-dentist, and that’s something we can all be grateful for! At Loreen Wong Dentistry, we use the latest and greatest tools to offer all of the dental services you need.