By Certifiably Kissable
After 15 plus years working on Wall Street and five years managing all things financial for a California dental practice I’m still surprised how people leave “easy” money sitting on the table. I’ve spoken to many patients who will drive to multiple grocery stores to save a few dollars yet they don’t take full advantage of their dental benefits. Then there are the patients who know how to get the most out of their dental benefits. What they do is simple. It’s easy.
Understanding your dental benefits and navigating the dental insurance companies is not easy. The dental lingo, the terms and conditions of the coverage, knowing what department to talk to for what questions. It’s often time consuming and confusing. The good news is there is someone in your dental office that knows the in’s and out’s, they deal with insurance companies on a day to day basis, and they want to help you. Take advantage of this knowledge and ask your dental office for assistance. They love to help; it’s what they do.
There are two areas you should ask for help, (1) Dental Exams, X-Rays & Cleanings and (2) Treatment Planning.
DENTAL EXAMS, X-RAYS & CLEANINGS
Cleanings: Your dentist is going to recommend a cleaning schedule to you based on your personal dental health. The frequency will vary based on your personal needs, it may be every six months, every 4 months or even every 3 months. Although many insurance companies limit their coverage for dental cleanings to every six months, it’s your personal situation that will dictate your cleaning needs.
What You Need to Ask About Your Dental Cleanings
- What is my recommended cleaning frequency?
- What will insurance cover?
- How do we need to schedule the cleanings so that I can maximize my yearly benefits?
- Do I need to schedule or change my scheduled appointment for this year to maximize my remaining 2017 dental benefits?
Comprehensive Exam & X-Rays: Your dentist is going to have a “standard of care” by which they want x-rays taken and to see you for your exam. What the doctor wants and what your insurance plan covers is not always in sync. Your dentist cares first and foremost about being able to see what’s going on in your mouth, your insurance company does care about keeping you healthy, however, they are most concerned with managing their expense.
- Ask your front desk when you are due for your next round of x-rays and exam.
- Based on when those x-rays and exam are expected, ask if your insurance will cover the exam and x-ray if done before the end-of-year.
- If you’re insurance will cover the exam and x-ray before the end-of-year, ask if it makes sense for you to make an appointment.
Treatment Plan: A treatment plan is a comprehensive list of the dental work that your dentist is recommending to be done. Some of this work is more urgent to be done and can easily be prioritized by your dentist if you can’t or don’t want to do all the work at one time.
What You Need To Ask Your Dental Front Desk Person:
- What is the list of dental work I need to have done and why?
- What is the urgency of the work to be done?
- How can I maximize my existing insurance to get this work done?
- Can we do some of the work now in 2017 and then what’s remaining or what makes sense in 2018 to maximize my insurance?
If you have an FSA (Flexible Spending Account) please be sure to tell your front desk person how much you have remaining so they can see how you can use your remaining money. If you don’t use your FSA, just like dental benefits, you lose it at the end of the year, there is no carry over.
If you have a HSA (Health Saving Account) this money can be carried over to the next year, however, you may want to use it to get your dental work completed. If this is the case, be sure to ask your front desk person to validate what your HSA will cover based on your treatment plan needs.
A MUST DO: Your dental office only knows what your insurance paid for the services they provided for the year, they do not know if you used your insurance elsewhere. It’s important you call your insurance company and validate how much coverage you have left. Your dental office will take care of everything else regarding your dental insurance. If you don’t know how to find out this information, ask your front desk person.
Maximize Your Dental Benefits
One thing you need to remember, your dental insurance is a benefit. It is not a recommendation or guideline for treatment. Your Insurance plan put together the coverage based on what your employer or yourself is willing to pay for that coverage. Dental plans have annual limits and coverage restrictions. We are quickly coming up to the holidays and end-of-year, call your dental office today to see how they can help you get the most out of your remaining coverage.
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