How to Maximize Your Dental Benefit Plan

October 31, 2017by Daniel Skillman

One of the worst mistakes people make with their dental benefit plans is to not use them. Statistics state that a very low rate (only 2.8%) of plan holders uses up or reaches the maximums of their plan benefits. A lot of money is being wasted because a good majority of people do not fully understand how their plans work.

To make sure your hard-earned money will not be wasted, you might want to take another look at your plan. Here’s a simple guide on how to better understand your dental insurance, so you can make the most of what you paid for.

The Basics on Dental Insurance

There is a variety of dental health insurance plans that cater to the different needs of their customers. Majority of the plan holders get their plans from the companies they work for or through their employers. There are also those who opt for individual plans for themselves or for their families. Features and range of coverage will differ depending on the design of the program but the most common types include:

  • Direct Reimbursement – This type of program allows plan holders to go to the dentist of their choice. A predetermined percentage will be reimbursed to the patient, regardless of the category the treatment falls into.
  • Usual, Customary and Reasonable (UCR) – UCR programs pays the patient a percentage of the doctor’s fee or the customary fee limit, which is derived from the contract of the third-party payer and the plan holder. Patients are also usually allowed to choose their own dentist.
  • Capitation Programs – In capitation payments, there is a fixed, pre-arranged amount received by the dentist or clinic. The dentists get this payment whether or not the patient seeks their service.

When To Use Your Benefits

Typically, the deadline of benefit plans fall on the end of December. For standard plans, unused benefits are usually not carried over to the next year. However, this may differ depending on the health care provider and the plan’s design.

How To Make The Most Of Your Benefits

Make the most out of your dental benefit plan and make sure you get your money’s worth. Here are some tips to help you out:

  • Use your benefits early in the year. Schedule an appointment with your dentist and plan ahead. Discuss your dental needs and other treatments you want to do. If you take care of this before fall comes, you will be able to maximize your plan even before the holidays.
  • When you have already listed out the treatments you need, make sure that they are covered by your plan. It is important to work with your dentist to find out which treatments you can take advantage of, or what workaround you can do to get the dental care you require.

Understanding Flexible Spending Accounts

A Flexible Spending Account, also known as a Flexible Spending Arrangement, works a lot like a debit card that you can use for dental expenses. Individuals will have the option to choose the amount to put in the FSA account as well as how much will be deducted from their paycheck.

When To Use Your FSAs

Just like the standard dental plan, FSAs also expire by the end of December. However, some companies are a little more lenient and give account holders a grace period of up to two months after the expiration date. Some also allow unused money of up to $500 to be carried over for the following year.

Here are some simple tips to help you make the most out of your FSA:

  • Plan ahead carefully. Even before enrolling for an FSA, consider what treatments you will need and how much you should be putting into the account. This will help you avoid putting in too much money in the account that you won’t be using.
  • Have a talk with your dentist to figure out the dental procedures for you. It is much better to make appointments during the summer, so that your treatments will already be well laid out for the last quarter of the year.
  • Contact an FSA administrator to better understand the services and products covered in this kind of account.

Saddleback Dental in Mission Viejo, CA provides personalized care, quality dentists you deserve. Services include cosmetic dentistry, implants, extractions, family pediatrics, and root canals.

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