According to the National Association of Dental Plans, approximately 77% of Americans had dental benefits in 2016. Most of these individuals obtain dental benefits through their employment while some receive benefits through groups such as AARP or as part of a medical plan. Those with dental benefits are more likely to go to the dentist, and less likely to have larger health problems that stem from untreated dental disease. This is a good thing!
However, another statistic from the National Association of Dental Plans is that only 2.8% of people with preferred provider organization dental plans reached or exceeded their annual maximum. This means that 97.2% of people may be leaving money on the table at the end of the year, because when January 1st comes, those benefit dollars are lost. Where do they go? The money remains with the insurance companies as easy profit. I suppose this is a good thing if you are a shareholder in the company. But in most cases it is a bad thing because people are losing their hard earned money.
Most employers that provide dental benefits have their employees pay at least part of the premium for the plan. So individuals who choose not to use their dental benefits in a given calendar year end up losing that money. In addition, deductibles will typically reset at the beginning of each year as well, which means more money coming out of your pocket.
So I’ve just mentioned three important reasons (lost premiums, unmet annual maximums, and deductibles that reset) to maximize the use of dental benefits each year. Are there any other reasons? YES! Unfortunately dental disease does not get better on its own. I wish I could help everyone understand how much better it is to do a filling now while a cavity is small versus a root canal and crown or an extraction and tooth replacement with a bridge or an implant and crown . . . a couple of hundred dollars versus a couple of thousand dollars! That is a big difference.
Another reason to maximize dental benefits is inflation. Just as milk and cheese and bread increase in cost with time, so does dental treatment. If it is possible to treat dental disease early and efficiently, patients not only save money because of insurance coverage and less expensive treatments, but also because they are able to avoid inflationary price increases.
So, how does one find out how much benefit is left on their insurance plan for the year? Call your dental office and talk with the insurance coordinator. They should be able to look up your plan specifics, tell you what you have used so far this year and what you have left, and help you plan how to maximize your use of your remaining dental benefits. If you have been to a dental specialist office you should call there as well as each individual office can only see what benefits you have used in their respective office. That will help you have a more complete picture of the benefits you have used and what you have left to work with.
Yours in good dental health,