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Use It or Lose It! Maximize Dental Insurance By Scheduling With a Dentist

October 9, 2018

Filed under: Uncategorized — dryoung @ 8:55 pm

A dental insurance claim form You probably don’t think about your dental insurance as “free money,” but in some ways, that’s exactly what it is! But, unfortunately, many people let their benefits pass them by. In fact, a recent study by the American Dental Association found that the average person has an annual benefit of $1,250, but only gets about $323 of dental work each year. Since you lose your benefits if they aren’t used by the end of the year, that’s like missing out on over $900. And you may as well achieve great oral health and beautiful smile – at a greatly reduced cost to you. Keep reading to find out which procedures are usually covered and how you can maximize your benefits!

Which Procedures Are Usually Covered By Dental Insurance?

Since there are so many different plans out there, it’s important to check your individual benefits to see what percentage of each procedure is covered. With that said, here are some average rates of coverage for several common procedures:

  • Cleanings, X-Rays and Exams – Since these are preventative, they’re typically covered at 100%. Patients usually get 2 checkups a year, although patients with diabetes, cancer, gum disease or who are pregnant may get more. Also, check your plan to see if it covers professional fluoride treatments, which are excellent for cavity prevention.
  • Deep Cleanings – Often recommended for patients with gum disease, deep cleanings are usually covered at 60%-80%.
  • Fillings and Root Canals – Insurance plans generally cover 50%-90% of the cost of fillings and root canals.
  • Crowns and Bridges – Many plans will cover crown and bridgework at 50% – 70%.

Some Things To Keep In Mind

To start, make sure to find out when your benefits will renew. Most plans start January 1st and end December 31st, but some begin and end on a fiscal calendar year. Also, be sure to find out what your deductible is so you’ll have a better idea of your total fees.

You can also ask your dentist to file a preauthorization beforehand if you’d like an estimate of what a procedure will cost. This document from your insurance company provides a breakdown of the coverage they’ll provide.

And remember, your insurance plan sets aside a certain amount of money each year that they’ll pay for your dental work. Usually $1,000-$3,000 per person, this “annual maximum” will be lost if you don’t use it.

Finally, don’t forget to schedule your checkup or other appointment with a dentist as soon as possible, as schedules usually fill up towards the end of the year.

With these tips for maximizing your dental insurance, you can rest assured that you won’t let another year of “free money” pass you by!

About the Author

Having been a dentist for over 4 decades, Dr. Larry Young knows that insurance benefits can be overwhelming for patients to understand. That’s why he and his staff do everything they can to help their patients maximize their benefits. If you have any other questions about dental insurance, he can be reached via his website or at (904) 731-9833.


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