Here at Dr. Dave’s in SE Portland, we are constantly striving to help our patients. We feel it is important to make sure it is known that if you do not use your insurance benefits you lose them, and in some cases even lose the money you have paid towards dental procedures.
Did you know that only 2.8% of people with PPO plans reach or exceed their plan’s annual maximum? This statistic is from the National Associate of Dental Plans. Each year millions of people leave their hard-earned money on the table when it comes to their owed insurance benefits. We don’t want to see our patients (or anyone) let their dental benefits go to waste.
Different Types of Dental Plans
Many people with dental benefits get them through their employers or individual plans available through Health Insurance Marketplaces. There are many different insurance providers and plans available. When you buy a plan, you or your employer pay a premium. If you fail to see your dentist, this money goes to waste.
Insurance Benefit Deadlines
Many insurance companies have a deadline of December 31st to be able to receive covered dental benefits. Benefits generally do not roll over into the new year. Not all plans follow the January 1st to December 31st timing. Some plans or insurances may use a different “start” and “end” date mid-year. It is important to check your documents or call your insurance provider to be sure.
Use Your Benefits Before You Lose Them
Most insurance companies will fully cover, with no cost out of pocket to you, preventative services – such as oral exams, x-rays, cleanings, fluoride treatments and even sealants (for certain ages).
Your deductible (amount you are required to pay out of pocket to cover additional services) typically re-sets at the beginning of the year. If you have already paid all or the majority of your deductible, and you still need additional dental services or treatments, it is a good idea to get in and have these taken care of – especially if you anticipate those services to be costly. Your insurance will likely pay the bill so long as your required service is received before the end of the year or the re-set date as laid out in their terms.
FSAs (Flexible Spending Accounts) are a use-it-or-lose-it type deal. This is an arrangement usually provided by your employer which allows you to have a certain amount of money deducted from your paycheck. This money can essentially be used just as you would a debit card. You can use the funds to cover a wide range of services from preventative to braces, crowns, and dentures. There is a cut-off date to use these funds and any money you have not used is gone!
Importance of Getting Treatment
We want to stress that it is always better to take care of your dental needs sooner rather than later. Financial concerns should never come in the way of getting your needed treatment or service. Too often we have had patients come to us needing urgent or extreme care, but if they had come in earlier, the treatment would have been simple and painless.
Here at Dr. Dave’s, we accept a wide range of insurances to make it as easy as possible for everyone to get needed care. Many offices, including ours, accept financing arrangements through 3rd party providers such as CareCredit®.
If you are worried about what your insurance will cover, please do not hesitate to call or contact our Office Manager and Staff to help you figure it out.
Sincerely,
Dr. Dave Carothers, DDS
Carothers Family Dentistry