If You’re Paying for Dental Insurance Coverage and Don’t Use It, You Lose It
If you have signed up for a dental insurance plan either individually or through an employer, you have a set amount of coverage to use each benefit year for needed dental work. As you (or your significant other or parent) are the one who purchased the plan, you are responsible for knowing all aspects of your dental insurance before using it. After you sign up for a plan you are sent a handbook which goes over your plan’s covered benefits, its annual maximum and deductible, and any waiting periods or stipulations that may affect your coverage while using your plan.
However, many people don’t realize that if you do not use your benefits up before your plan’s renewal date, you are losing your benefits as well as losing money out of each paycheck to pay for something you aren’t using.
How Does the End of My Dental Insurance Plan’s Benefit Year Affect Me?
One of the most common things we see is patients losing their annual coverage by waiting until a later date to get their needed treatment done. Simply put, the issue with doing this is that you are paying your dental insurance company out of every paycheck for an amount of money that will cover your needed dental work work that reduces or, in some cases, even eliminates your out of pocket cost for dental appointments. However, after your plan renews, you lose what you’ve already paid for! It’s like throwing your money right out of a window.
If you have coverage for dental procedures that you have to get done, and you have plenty left to use of your annual maximum, try to get your work scheduled and completed before your plan’s renewal date. We here at The Center for Periodontics and Dental Implants can even help you plan out your needed treatment based on what benefits you have left. We can help you find out how much you have left of your annual maximum, what will be covered of your treatment, and let you know your estimated out of pocket costs (but remember, all estimates, from us and from your dental company, are always just that: estimates).
Check Your Benefit Rollover Date
First and foremost it is very important to know exactly when your dental insurance benefits renew. Most plans rollover the first of each year – January 1st of every year – regardless of when you signed up during the previous year. However, there are still many plans out there that renew at different times. For example, some plans renew their benefits July 1st or August 15th; it can literally be any time during the year.
Knowing when your benefit renewal date is for your dental insurance tells you exactly how much you have left of your maximum every time you have a dental appointment, and then helps you calculate what you have left for your particular “benefit year.”
Your Annual Maximums and Deductibles Renew
On your particular dental insurance plan’s renewal date, your annual maximum will renew. For example, if you have $1,500 to use per benefit year, and you have used $1,037 of it, the day your plan renews it refreshes your maximum and you then have $1,500 to use again for the new benefit year.
The same applies to your annual plan deductible. If you have a deductible that you have met, once your dental insurance plan renews, you now must meet your deductible again. Many plans have a small deductible such as $25 or $50, but some can be a bit higher, so it is always a good idea to know what your deductible is, and that you will have to meet it again once your plan renews. This can add more to your out of pocket costs if you wait until the next year to get treatment done, as well.
Always Review Your Plan Before You Use It
No matter what time of year you use your dental insurance benefits, it is extremely important to know your plan and what is available to use before each appointment you schedule. It can be reviewed in the packet of information your insurance company or HR department sent to you after signing up, or it you can discuss with a dental insurance representative by calling the customer service number on your dental insurance card.
Below is the most important information you need to know about your dental insurance plan before scheduling any appointment at a dental office or specialist clinic such as a periodontal office like us, The Center for Periodontics and Dental Implants.
What Information Do I Need To Know Before Scheduling an Appointment?
- your plan’s benefit renewal date (rollover date)
- your annual maximum and deductible
- any waiting periods or stipulations your plan may have
- your benefits in and out of network
- what providers you are allowed to see (which is determined by your insurance company)
Almost Every Single Plan Is Different, and There are Millions of Them
It is very important to know that your insurance coverage is your responsibility. This means you are responsible for knowing where your plan is accepted, what is covered and what is not, as well as all plan information outlined by your dental insurance company. This also means you are financially responsible for any work your insurance ends up not covering, regardless of why.
Don’t Play the Waiting Game – It Could Cost You More Than Money
If you know you have needed treatment to be done sooner rather than later, and you have dental insurance benefits left, give us a call. Schedules tend to fill up around the holidays, and the longer you wait, the more likely it is that you’ll end up needing bigger treatment, which could end up costing you more money, your health, and even your teeth themselves! Don’t delay!