How to Maximize your Dental Benefits

November 13, 2017

Now that summer has ended, fall has arrived and our routines are back on track. Kids are back in school and have made it through that first adjustment period, we’re no longer trying to spend every moment we can in our limited sunshine, and this change of weather brings a little bit of a slower pace to the Peninsula. All of this makes fall a great time to schedule necessary dental work and maximize your dental benefits. 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.

Capitalize your dental benefits before they renew

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. Some dental procedures require multiple appointments and knowing your benefit year is a great way to get the most coverage for each visit.

Understanding what your dental plan covers and its 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. Dealing with dental insurances on a daily basis, we do our best to understand your plan allowing 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. There are also some instances where insurance companies will only work directly with the subscriber.  Some important things to know about your plan:

 

  • What kind of benefit year does your insurance carry (Fiscal/Calendar)
  • Your annual deductible amount
  • Your annual maximum benefit
  • The number of hygiene visits covered per year
  • The number of exams covered per year
  • How often X-rays are allowed
  • The number of fluoride treatments covered per year
  • Understanding if your insurance covers services based off of a fee schedule or percentages
  • If you have coverage through multiple insurance companies how do they coordinate coverage with each other

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 visits 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 costlier dental procedures. It is important not to delay necessary treatment, as the condition will likely worsen and become more expensive to treat.

Request a pre-treatment estimate

If major dental work is needed, the best way to have an estimate of  the treatment cost is to request a pre-treatment estimate, also known as a pre-authorization. Although this is not a guarantee of payment, it allows you to obtain the most accurate estimate prior to completing treatment.  A pre-treatment estimate will also notify us of any limitations, waiting periods, or maximum benefits reached.

Going 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 some of them. Laurel Dental Clinic 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 your dental office aware of any changes with your insurance

At Laurel Dental Clinic we have staff designated to understanding your insurance benefits and helping you utilize them. 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.

Schedule now

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. With most insurance companies renewing the first of the year, our schedules do fill up! Please feel free to call our office, (360)452-9744, and let us assist you in utilizing your own dental benefits.


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