If you have dental insurance, there are three important facts you need to know.
Fact 1: No plan is a pay all plan.
Most dental insurance is designed to help with routine dental care. Coverage varies quite a bit from insurance company to insurance company and plan to plan within each company in terms of what procedures are covered, the percentage covered for each procedure and the maximum yearly benefit.
Most patients have gotten the impression that their insurance will pay for up to 90-100% of their dental fees. In actuality most plans cover far, far less. The percentage you receive is determined by how much you and/or your employer have paid for coverage. The less paid for the insurance, the less you will receive in benefits. In addition, dental plans have yearly maximum benefits and deductibles which again vary by company and plan offered. When considering which dental plan to accept it's a good idea to carefully read the policy to ensure that the coverage offered meets your (and your family's) needs. And when considering treatment, it is always a good idea to review your coverage to reduce the likelihood of surprises.
Fact 2: Maximum benefits end at the end of the benefit year.
Whether your dental insurance plan is in effect from January to December, or July to June, whatever benefits you haven't used by the end of the benefit year disappear. Use it or lose it! At the beginning of the next year your benefits are reset to the maximum. In all but very rare cases, there is no carry over of unused benefits. If there is prescribed treatment that you have not completed, you will want to review the costs of that treatment against your remaining benefits. If you have benefits left, it's a good idea to schedule dental procedures prior to the end of the benefit year with an eye to maximize your benefits.
Fact 3: Dental Insurance is based upon a contract between your employer and the insurance company.
We do our best to work with you and your insurance company so that you get the best coverage for treatment. Unfortunately insurance companies do not publish how specific treatment will be covered, therefore, we can only provide you with an estimate of the expected insurance coverage. Should questions arise regarding your specific dental insurance benefits and how the insurance will cover treatment, it is best for you to contact your employer or the insurance company directly.
We will always do what we can to help you maximize your benefits. Here are some things you can do to maximize your benefits:
- Use your benefits for routine care to help prevent more serious and expensive procedures in the future.
- Don't wait until December to use the remainder of your insurance (if your benefit year resets in January). A good time to call our office to schedule an appointment is before November 1st.
- Remember you and/or your employer paid for your dental benefits. That makes it YOUR money - don't let it slip away!
Call us at (630) 858-1232 so we can help make sure you get all the care and all the benefits you deserve.