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Dr. John Paul Gallardo

Periodontics and Implant Dentistry

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New Year, New Insurance: How to Maximize Your Dental Benefits

During open enrollment last year, you might have chosen a new dental insurance plan. Or, you might have decided to purchase a dental policy for the first time. If so, you’ll want to maximize the benefits you’re getting out of your new plan in 2019. Although it’s always a good idea to use up your benefits before they expire, don’t wait until December to start taking advantage of your benefits. Making a plan for using your dental benefits at the beginning of the year can help you avoid that end-of-the-year rush.

Whether you’ve got a new policy or renewed the plan you had in the past, here’s what you can do to make the most of it.

Step 1: Figure Out What Your Benefits Are

Like health insurance, dental insurance plans come in a variety of shapes and sizes. Depending on how you purchased your plan, however, you might not have had much input into choosing what’s covered.

Take a few minutes to learn more about your plan. Find out what procedures it’s likely to cover and which ones it won’t. It’s also important to find out how much of the treatment cost a plan covers. For example, some plans offer 100 percent coverage for preventative care or for certain treatments such as cavity fillings, but might not offer coverage for cosmetic treatments. Some plans might pay 50 percent of the cost of certain procedures while covering others fully. Each plan is different, and it’s your responsibility to understand what charges you may incur.

Some policies also have an annual maximum, meaning they won’t cover the cost of treatments once a certain dollar amount is reached.

If you’ve had a dentist you’ve been seeing for years, it’s also a good idea to verify that their practice accepts your new insurance policy.

Step 2: Know Your Deductible

Many dental insurance plans have a deductible. The deductible is the amount you need to pay out of pocket for the plan starts paying. The cost of your deductible usually depends on how many people are on the plan and what you pay for the monthly premium. Often, the lower the premium, the higher the deductible. Having a family insurance policy instead of an individual plan also typically means a higher deductible amount, since the plan covers more people.

Step 3: Find Out if You Have an HSA

If you have a health insurance plan with a high deductible, you might also have access to a health savings account (HSA). An HSA lets you set aside money, before tax, which you can then use to pay for medical expenses, including dental treatments. If you do have an HSA, you’ll want to ask a few questions. Find out what the maximum amount you can contribute annually, where the account is located, and what your savings and investment options are. It’s also a good idea to start contributing to the account as soon as possible so that you have the money set aside to cover the cost of deductibles and any other out-of-pocket dental expenses later in the year.

Step 4: Schedule Preventative Care

After you’ve figured out what your benefits are and what deductible you are responsible for, it’s a good idea to start scheduling any preventative care appointments. Pick a time to call up a dentist and schedule your next cleaning, if you don’t already have one on the calendar. Preventative dental care not only gives you the opportunity to treat issues such as tartar and plaque build-up and tooth decay, but it’s also a chance for a dentist to examine your mouth and detect any gum disease that might be present.

Gum disease affects more than half of the adult population and is the leading cause of tooth loss in adults over age 35. In the earliest stages, gum disease is reversible. Once it moves to the later stages, treatment can help to save your teeth and fix your gums.

Step 5: Schedule Other Important Dental Treatments

If your dentist recommends any other dental treatments, such as replacing missing teeth or removing your wisdom teeth, it’s a good idea to schedule those treatments sooner in the year rather than later. Scheduling any needed treatments as soon as possible not only lets you “get them over with,” it also helps you use up your deductible. If you wait until later in the year, you might find that you still need treatments after the year’s over and your deductible has reset. Plus, you’ll be ahead of everyone else trying to use up their deductible!

Your dentist is there for you to help you decide which treatments are most appropriate and to help you schedule those treatments to maximize your insurance benefits. Dr. John Paul Gallardo is a periodontal specialist in the Miami area who also offers dental exams and cleanings. He can recommend options that are right for your needs. To schedule an appointment in Miami, FL, call 305-547-8687 today.

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Reviews

  • My experience with Dr. Gallardo was great. I had no pain after my tooth extraction and bone grafting procedure. I was pleased with how fast my…

    • 5 stars
  • Amazing! Removed my 4 wisdom teeth, had no pain and didn't get swollen at all after.

    • 5 stars
  • I recently had a tooth extraction with bone graft. Dr. Gallardo was excellent! I'm so glad I found him online. My recovery went really smoothly…

    • 5 stars

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