Truth: 95% of dental plans financial limits end December 31st. What does this mean to you? It means that you may be missing out.
You may be missing a year of benefits that you could have used up. If you have a few treatments scheduled, getting some completed in 2015 means that there will be a full year of benefits to use in 2016.
Many people never use their insurance benefit. Sometimes they don’t have a habit of visiting the dentist and sometimes it is due to high anxiety.
For those who prefer to be treated through sedation, it is covered by most insurances. To be certain of the coverage the dental office would send in a preauthorization form. The answers come back sometimes in a few days and sometimes in a few weeks. Due to the privacy act, many insurances will only send the information of the approval just to the patients. Every insurance policy is different.
Here is another truth. Did you know that if you have coverage for a cleaning every 9 months, this does NOT mean that you are eligible for a cleaning only every 9 months. Most plans are broken into two categories. The plans are written to allow polish, fluoride and an exam every 6 or 9 months. However most plans have more room for tartar removal which is the hygiene treatment that really keeps your gums healthy.
What you need to look up on your plan is how many units of tartar removal you have allowable. This is usually called scaling or root planing. The average dental plan allows from 4 units to 16 units. What does that mean to you? Every time you go in for a cleaning with your hygienist, the average units used is two to three units. You could come and use the other available units of tartar removal and use up the allowable units every 4 months or 6 months as you need. Tartar removal helps maintain the health of gums, and prevents bone loss. Regular tartar removal encourages less bacteria build up and can help gums to reattach. Some people build up tartar faster and may have more gum problems. It is not just personal hygiene. It could be your chemical makeup in your saliva, or if you are taking medications that keep your mouth drier. So it is smart to look up your coverage for tartar removal and use the coverage appropriately.
This extra dental care is even more important for pregnant women who should see their dentist every three months. Hormones during pregnancy can significantly damage gums and the extra bacteria that accumulates can be detrimental to the health of the baby. If you are past the age of 65, you also might require more oral health assistance than every six months. Added medication can dry your mouth which leads to faster decay. You may need more than your dental plan provides, so understanding your plan is very important. In the end, dental insurances are there to help and provide more but they are not there to provide the treatment that you require.
Your dental office, has the experience with all different kinds of insurance coverage. Although you are ultimately responsible for your fees and your dental insurance, you can count on your clinic to do their best to help you decipher what is covered and will work with you to maximize your dental coverage. If you want to use your plan and not lose it for the year, call the dental office sooner than the end of December. Some treatments need to be preauthorized and that takes time.
You’re probably covered for more than you think, so choose health. You’ll be glad you did.