The phrase, “Use it or lose it,” could be applied to a lot of things in life. If you learned a second language in high school but haven’t used it in years, you may have lost it. If you had strong abdominal muscles at one time but haven’t done a sit-up in 20 years, you may have lost them too! And, although you probably don’t think about missing out on your dental benefits by not seeing a dentist, it happens more often than you would expect. Since your insurance plan sets aside a certain amount of money each year, if you don’t use it, you lose it. Keep reading to find out how to avoid losing your benefits and learn what kind of coverage the most common procedures have. You may as well take advantage of your insurance benefits – otherwise, it’s like passing up free money!
Which Procedures Does Insurance Cover?
Here are some estimates for the coverage that the most common procedures typically have. But, as always, it’s important to check your individual plan because each one is different.
- Cleanings, X-Rays and Exams – Since these procedures are considered preventive, they’re often covered at 100%. Most patients get 2 checkups a year, although more frequent visits might be covered for patients who are pregnant or have diabetes, cancer or gum disease. Also, fluoride treatments may be covered by your plan, which strengthen the teeth and prevent cavities, so always check your benefits.
- Deep Cleanings – For patients who have gum disease or need a more thorough cleaning, deep cleanings are usually covered at 50%-90%.
- Fillings and Root Canals – Insurance plans generally cover 50%-90% of the cost of fillings and root canals.
- Crowns and Bridges – Crown and bridgework is typically covered at 50% – 70%.
How Can You Maximize Your Benefits?
First, you’ll want to make sure that your dentist is in-network with most major PPO plans, because you’ll get the biggest possible discount that way. Also, make sure you see someone who is willing to help you navigate your insurance plan by explaining your benefits and filing claims for you.
They should also be willing to file a pre-authorization with your insurance company prior to doing a procedure, which is a formal estimate of what your final cost will be.
One final tip: Don’t forget to schedule your dental visits sooner rather than later, as everyone’s schedule gets busier as the end of the year approaches.
There’s nothing worse than realizing you missed out on a good financial opportunity because you didn’t take advantage of it in time. By being proactive about your insurance benefits and using these strategies, you can be sure you don’t miss out!
About the Author
Dr. Joanne Bancroft is a general, restorative and cosmetic dentist who is in-network with many of the major PPO plans in her area. She and her staff know that navigating insurance benefits can be overwhelming for patients, so they do everything they can to make it as smooth as possible. If you’d like to know more about how to use your insurance benefits, she can be contacted via her website or at (720) 458-6561.