Use It or Lose It: Three Things You Need to Do to Get the Most Out of Your Dental Insurance

The end of the year is a time to reflect on all you have accomplished in the past 12 months and remember what you still have left to do - like use up your dental insurance benefits! Some dental insurance plans require you to use up your benefits throughout the year or risk losing them in the next. That’s why December is an excellent time to visit the dentist. While we previously discussed what to do if you don’t have dental insurance, today we’re taking a look at how to get the most out of your dental insurance benefits.

Know Your Benefits

How do you know if you have “use it or lose it” insurance benefits? Get the most out of your dental insurance plan by gathering information on your maximum benefits available (MBA) and your explanation of benefits (EOBs).

First, you will need to locate the full explanation of your dental benefits, whether online or on paper. Before looking over everything in your EOBs, search just for your MBA , which is the maximum amount of money your dental insurance will pay for a variety of dental work in the span of a year. Anything not used by the end of the year is lost and does not roll over. You’ve already paid for your insurance benefits, so you might as well use them!

Next, collect your EOBs sent from your dental insurance carrier after all of the dental work you have had performed over the year, and examine them in detail to see how much your dental insurance has paid to cover it. Totalling this amount and comparing it to your MBA will reveal how much is left that you can use towards dental work by the end of the year. EOBs and other insurance documents can often be confusing, however, so it can be useful to directly call your dental insurance carrier for assistance and to ask how much of your MBA is left.

Make the Most of Your Plan

So, it’s nearing the end of the year, and you want to make sure you get the most out of your dental insurance plan. What are the best ways to use your dental benefits so you don’t lose them? Consider these options:

Visit your dentist for one of your semiannual dental appointments to receive a teeth cleaning and other preventive dental work. This is one of the easiest options to keep up your oral health and to take advantage of your dental benefits, as most insurance plans will completely cover preventive dental appointments.
Discuss dental plans for the remainder of the year at appointments in the summer or fall months, so you can plan and know what to expect. This helps ensure that there won’t be a scramble to use up your insurance benefits come December, along with everyone else.
Make sure you know what’s covered by your dental insurance and which treatments are not covered. This will help you determine how to effectively plan out your appointments for the rest of the year and into next year. Your dentist office should be able to provide information about what your insurance plan covers, but you can also directly call your insurance provider or visit their website to learn details.

If you have a Flexible Spending Account (FSA) through your employer rather than dental insurance, the steps to take to get the most out of your plan are similar. Some FSA plans end on December 31, while others may extend a grace period to use the remaining amount left in your account or allow for a maximum carry over amount for the next year. Only put as much as you expect to spend through your FSA for dental work, discuss treatment coverage with your dentist and FSA administrator, and plan your dental appointments in advance.

Call and Schedule an Appointment

If you need to use up your dental insurance benefits by the end of the year, consider NK Family Dental for your top Chicago dentist and periodontist. See our list of accepted PPO insurance plans and other financing options, along with our many services. Then, call us to schedule your appointment ASAP before December 31! We look forward to treating you in this year and the year to come.

Need a Dentist, but Don’t Have Insurance?

While it is known that oral health greatly impacts your overall health, most Americans unfortunately do not have dental insurance. Because of this, many people often forego visiting the dentist for as long as possible until an emergency occurs or until severe oral/dental conditions arise. Skipping the dentist because of a lack of dental insurance can lead to an increased risk for many oral and overall health conditions, including gum disease, tooth loss and heart disease. While you can still receive treatment in the event of a dental emergency, the extra expenses will burn an even deeper hole in your wallet. This is why it’s important to have a plan in place and know your options for both urgent and general dental care services.

Let’s discuss the different levels of severe and urgent dental needs, how to prepare for emergencies, what preventive measures you can take and what affordable options are in place for individuals and families without dental insurance.

Know What Is Urgent, and Have a Plan

As we discussed in our previous blog, “How to Know if It’s a Dental Emergency,” it’s important to know the difference between urgent dental matters and dental emergencies that require immediate attention.

Dental emergencies that require immediate treatment include:

A cracked tooth
A broken tooth
The sudden loss of a permanent tooth not caused by injury

Other dental issues that may only require an urgent appointment with your dentist include:

Dull toothaches
Lost or loose fillings, crowns, or bridges
Damaged retainers

Because dental emergencies can happen anywhere and at anytime, having a plan in place can greatly reduce stress and the potential for long-term damage. No matter the level of pain or discomfort, visiting your dentist or hospital (according to the severity of your condition) as soon as possible is crucial to maintaining overall health. Don’t let a lack of dental insurance cause further dental and medical conditions to arise or worsen.

What Are Your Options?

A thorough oral care routine does not replace the need for semi-annual check-ups at the dentist, nor can it completely keep dental emergencies at bay. The best preventive measure you can take is to have dental insurance if possible, as this makes regular dental care more accessible. However, many families, young adults and senior adults do not have a dental insurance plan.

However, there are options available to uninsured individuals who are not able to pay dental fees at the time of treatment. When you don’t have dental insurance, you can:

Join a membership or payment plan with a dentist. - Memberships with your dentist’s office (if available) allow you to receive many basic dental care services at no additional cost or at a greatly reduced cost when you pay an annual fee up front or over time. These options provide no financing or interest, and they are a great way to receive affordable dental care that fits your budget better.

Look for charity events - Many non-profit dental organizations provide free or low-cost dental care through regular local charity events such as free service days. While they may serve as volunteers with the non-profit organization, the individuals who provide services at these charity events are licensed dentists and dental professionals, which means you will receive dental care you can trust.

Visit free or government clinics - Free or government dental clinics in your area work similar to charity events, in that dentists and professional dental staff volunteer their time to provide necessary and basic dental care to patients who could not otherwise afford it.

Try a dental school - Receiving dental treatment at a dental school clinic is another more affordable option. Dental students perform work under the careful supervision of licensed dentists. The main downside to this option is that getting an appointment may take longer compared to a traditional dentist’s office.

Avoid chain dental offices - Advertisements of chain dental offices can be deceiving. While they may claim to offer free and reduced services for new dental patients, these typically only apply to patients who already have dental insurance.

Be proactive - One of the best ways to reduce your need to go to the dentist beyond semi-annual checkups is through taking your own preventive measures. Maintain good oral health by brushing twice daily between two to three minutes each time, floss at least once a day and use an antibacterial mouthwash. You can improve your daily oral routine by using an electric toothbrush and in the evening using a fluoridated mouthwash.

We Have You Covered

If you don’t have the means to obtain dental insurance right now, there’s no need to panic. Many dental practices offer dental discounts with membership plans for individuals and families without dental insurance. Dental membership plans work by offering a variety of services included in the cost for an annual membership, combined with discounted rates for additional dental services. These plans ensure that you will still be able to maintain good oral health throughout the year, even without insurance.

For the best dental discounts with the best quality dental care in the heart of Chicago, look no further than NK Family Dental! Your NK Membership will include two general cleanings, exams, and X-rays at no additional charge to your annual membership. Additionally, you and your family will receive 25% off standard office fees, 10% off porcelain veneers cosmetic treatment, and a waived fee for the limited exam during an emergency visit if definitive treatment is completed on the same day as the exam. Members can also enjoy no yearly maximum and no deductibles or copays.

To learn more about our membership discount plan or to schedule your next appointment, contact NK Family Dental today!