Dr Pyle's Weston Dentist Blog

Weston Dentist Explains What You Need to Know About Dental Insurance to Start the New Year

It’s the start of a new year and Dr. John Aylmer, DDS suggests that now is a good time to review your dental insurance plan. Dental insurance policies come with a benefit period (usually January through December) that defines the benefits that can be paid during a 12-month period.

Typically dental plans offer generous benefits for 2 preventive dental visits each year covering 80% to 100% of the cost. Preventive visits include regular exams, cleanings, sealants and x-rays. The insurance companies are no fools. They know that regular dental exams prevent more costly procedures like fillings, root canals, extractions and implants. The more healthy their insureds are the less thy have to pay out.

The truth of the matter is your annual dental insurance premium is significantly greater than the cost of 2 routine dental exams. You stay healthy and they make money. They make even more money if you miss one of those dental exams during the 12-month benefit period.

When your oral health requires more advanced treatment don’t be surprised when your dental insurance only picks up 50% to 80%. They are generous with their preventive benefits but not so much when it comes to advanced care.

Reviewing Your Dental Insurance Plan Now Minimizes Surprises in the Future

Weston Dentist Insurance

Let’s make this year the year you maximize the benefit of the premium dollars you invest. Planning for those things that can be planned for will help manage your household cash flow. Here’s where you need to start:

  • Understand your dental insurance policy. Take the time to learn the ends and outs of your policy including maximum benefit for 12 months, coinsurance rates for different classes of service, and any limitations on your choice of dentist and claims procedures.
  • Budget for medical expenses. If your employer has a Cafeteria Plan (and most do) you can reduce your taxable income and save on employment taxes by having your employer withhold a budgeted amount each paycheck to place in your “cafeteria account.” These funds can be used to reimburse you for almost any medical expense (excluding over the counter drugs) you incur during the year. Braces for the kids or Lasik eye surgery are popular “cafeteria” projects. Just make certain that you use your account up within the benefit period otherwise you lose any remaining balance.
  • Plan now for dental exams. It is not too early to flag a date for each person in the family to get their preventive exams. Your dentist may or may not accept appointments that far in the future but the important thing are you have a reminder set to ensure everyone gets their exams. Keep in mind that the “busy season” for most dental offices is October through January as patients try to meet their benefit period requirements.

Like health insurance, dental insurance can be confusing to understand unless you work with it every day. If you are a patient feel free to call the office and we will be happy to answer your questions.

Diplomate of American Board of Dental Sleep Medicine

As a Diplomate of the American Board of Dental Sleep Medicine (ABDSM), Dr. Pyle is part of an elite group of dentists who have met the highest educational and experiential standards, possessing an in-depth level of knowledge in the treatment of obstructive sleep apnea using oral appliance therapy.

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