Getting the Most Out of Dental Benefits Plans

If you’re like most people, you probably don’t have a perfect understanding of your dental benefits or how to maximize your hard-earned dollars when it comes to paying for dental bills. Only 2.8 percent of individuals with preferred provider organization dental benefits reach or exceed their annual maximum, while others forget to take advantage of flex spending accounts. This means you may be leaving money on the table each year. Learn how you can maximize your dental benefits and ensure you take advantage of all your dental care options.

Dental Plans

Most people have a dental plan either through their employer, their spouse’s employer, or through the insurance marketplace established by the Affordable Care Act. This involves paying a monthly premium for dental coverage, regardless of whether or not you see the dentist. Since you’re paying for it, you might as well take advantage of it. But how can you do this?

For starters, make sure you’re getting regular preventative dental care. Usually, these are recommended every six months, and since prevention is preferred to treatment, these visits are often fully or majorly covered by your insurance. If your dentist finds a cavity that needs work, you’ll have to schedule another appointment, but that preventative cleaning is usually fully covered by your insurance plan, so take advantage of it.

Next, know your dental plan and talk to your dentist about potential issues. Most plans have a waiting period before a percentage coverage amount kicks in. This is to prevent someone from putting off major dental work until January 1 when they can choose a different dental plan. In many cases, preventative care is covered right away, minor work like cavities and sealants are covered after a couple of months, and major work like a root canal needs at least six months of premium payments before the insurer will cover a larger percentage of the cost. Talk to your dentist to see if any problems may be developing down the road, so if you need a bigger surgery in a few months or years, you can select a plan to offset more of the cost.

Please keep in mind dental insurance is a benefit used as a supplement and not designed to take care of all potential dental needs. If you have any questions about insurance coverage or eligibility, give them a call using the phone number on the back of your dental insurance card.

Flex Spend Accounts

Another way to pay for dental visits is through what’s known as a flexible spending account, or FSA. These are typically offered through your employer, and during the enrollment period, you decide how much of your paycheck goes into this account. Sometimes your employer will match a percentage or contribute in another way to your FSA, but even if they don’t, you’ll want to take advantage of it because it is pre-tax money. This means the money is taken out of your paycheck before taxes are withdrawn, which ends up saving you roughly 33 percent.

For example, instead of having that extra $200 on your paystub, which is then taxed and cut to roughly $130 on your direct deposit, that full $200 goes into your FSA and your paycheck is taxed at $200 less than normal. Instead of having $130 to pay for dental bills out of your checking account, you have $200 to spend out of your FSA.

The caveat here is your FSA can only be spent on certain things, like medical or dental bills. But, if you need dental work, you’ll end up cutting your bill down by about ⅓ if you can pay it out of your FSA. Your FSA covers a lot of dental work, like cleanings, insurance co-pays, hardware like braces or dentures, etc.

Some FSA’s expire at the end of the year, so be sure to learn about your account, so that money you have stashed away doesn’t disappear at year’s end. Some companies allow you to use it into the next year, while others allow you to carry over a portion or set amount of money, so just make sure you don’t have $800 in your FSA if you can only carry over $500. Learn the rules, and make sure you aren’t leaving money on the table.

For more information about dental insurance or maximizing your payment options, contact our team today.