Maximizing Dental Insurance Benefits

October 21, 2017

Fall is officially here!! Now that the kids are back in school and we are back into our routines, it may be time to visit the dentist. Fall is a great time to schedule necessary dental work and maximize your dental benefits before the rush at the end of the year.  Dental benefits are designed to provide you with assistance in paying for your dental care and maintaining a healthy smile.  If you have dental benefits, you want to make sure you are best utilizing your plan for your individual oral health needs. Here are a few tips to help you maximize your dental benefits; reducing out of pocket dental expenses.

Use your dental benefits or lose them

Most insurance plans have an annual maximum benefit available that will not carry over to the next benefit year.  Take advantage of any unused insurance benefits and/or unused Flex (FSA) or health savings (HSA) benefits you may have remaining. Most insurance plans run on a calendar year (January-December) however some run on a fiscal year. Be sure to know when your benefits renew.

Understand your dental plan benefits and limitations

Knowing your dental plan benefits and limitations prior to receiving services can often prevent unexpected expenses. Take the time to read through your member benefit handbook and use the latest online tools and resources; patients can track claims and their remaining benefit dollars online. We work with dental insurances on a daily basis, and we do our best to understand your plan. This allows us to provide you with an accurate estimate and schedule your appointments within frequency guidelines. Unfortunately, it is unrealistic for any dental office to track this with perfection.

Our office staff  can be a great resource and often help answer questions regarding your insurance, however contacting your insurance Customer Service Department directly with questions is usually best.  This time of year is usually when you are choosing your plan for next year.  Some important things to look for when choosing your plan:

  • Your annual deductible amount
  • Your annual maximum benefit
  • The number of cleanings covered per year
  • The number of exams covered per year
  • How often X-rays are allowed
  • The number of fluoride treatments covered per year

Take advantage of benefits offered by your plan

Dental plans can offer coverage for a variety of procedures. Ensure you are utilizing the benefits offered by your plan that meet your specific oral health needs. Some plans offer additional hygiene appointments when a patient has periodontal disease, Type II Diabetes, kidney disease, and cancer– to list a few. Studies show a strong connection between oral health and overall health. Regular dental visits that are often covered at 100% by your insurance can help prevent serious health problems. Also, taking care of needed dental treatment today can alleviate emergency dental visits, prevent missed time from work and school, and prevent dental problems from developing into more costly dental procedures. It is important not to delay necessary treatment, as the condition will likely worsen and become more expensive to treat.

Request a pretreatment estimate

When major dental work is needed, you can request that a pretreatment estimate be sent to your insurance.  We will gladly submit this for you.  Although this is not a guarantee of payment, it allows us to obtain the most accurate estimate prior to completing treatment.  A pretreatment estimate will also notify you of any limitations, waiting periods, or maximum benefits reached.

Go to an in-network dentist

Going to a dentist that is in-network with your insurance plan can provide the best benefits. Some dental plans have multiple networks, and your dentist may participate in all or only a few of them. Dental Care of Sumner is in-network with almost all insurance plans. We strive to provide quality, comfortable dentistry at an affordable price and want to allow the opportunity to best utilize your dental insurance to meet your specific oral health needs.

Keep current dental insurance on file

We are focused on making sure that you understand how to best utilize your dental benefits.  In order to provide you with the most accurate benefit information we need to have your most recent dental insurance on file. If you switch jobs or insurance plans, please be sure to notify us immediately; providing us with a copy of your dental benefits card is always helpful. This allows us to retrieve accurate benefits and submit claims to the proper insurance company.

Call us!

Overall our primary goal is to provide you with the highest quality dental care possible and we attempt to best utilize your dental insurance without compromising our diagnosis and the care you receive. Contact our office today to schedule.  We look forward to seeing you soon!  Call us at 253-863-2995.

 

References:

http://npdsmiles.com/maximizing-your-dental-benefits-at-the-end-of-the-year-3/

https://www.pacificsource.com/member/oregon/dental.pdf

https://www.deltadentalins.com/administrators/guidance/maximizing-a-dental-benefits-plan.html

http://www.vanosdelddsblog.com/maximizing-annual-dental-insurance-benefits/

http://sharonbenroohidds.com/maximize-your-dental-benefits/

 


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