The end of the year is a busy time for everyone. Amidst all the holiday preparations, it’s not uncommon for people to forget about the fact that their dental insurance benefits will be ending soon. Unfortunately, not scheduling with a dentist in Scarborough in time can cost them! In fact, a recent study by the American Dental Association found that, while the average annual benefit is $1,250 per person, most people only get around $323 of dental work annually. Since insurance benefits are lost at the end of the year, that’s over $900 that many people are passing up. Keep reading below to find out what insurance usually covers and get tips on how to take advantage of your benefits – before they pass you by!
What Procedures Are Covered By Your Insurance?
Here are some average percentages of coverage for many procedures, but don’t forget to check your individual plan because they’re all unique:
- Cleanings, X-Rays and Exams – At least try to schedule everyone in the family for their checkup before the end of the year because checkups are considered preventative and are usually covered at 100%. Most patients get two annual checkups, but more may be covered during pregnancy or for patients who have gum disease, diabetes or cancer. Also, check to see if your plan covers professional fluoride treatments, which are fantastic for cavity prevention.
- Deep Cleanings – Deep cleanings are a special type of cleaning that treats gum disease. They’re usually covered at 60%-80%.
- Fillings and Root Canals – Fillings and root canals are often covered at 60%-80%.
- Crowns and Bridges – Many plans will cover crown and bridgework at 50% – 70%.
Additional Tips For Getting the Most From Your Insurance
First, look at your plan to determine a few key pieces of information, beginning with the start and end date (many plans start January 1st and end December 31st).
If your plan ends in December, try to schedule any appointments as soon as possible, since many dental office schedules fill up quickly.
Also, check to see what your deductible is to get a better idea of what a procedure will cost. If you’d like a more specific idea, you can ask a dental office in Scarborough to file a preauthorization beforehand. This breakdown from your insurance company will tell you what they’ll pay so you won’t have any surprises.
Finally, find out what your annual maximum is (usually $1,000-$3,000), which is the total amount they’ve set aside for your dental work. Don’t forget – this is money you can use (instead of lose) to achieve a healthy, beautiful smile this year!
About the Author
A graduate of the UCLA School of Dentistry, Dr. Needhi Shah has over 10 years of experience as a general, cosmetic and emergency dentist in Scarborough. She knows that insurance can be overwhelming, so she and her staff do everything they can to help patients navigate their benefits. If you have any additional questions about your insurance, she can be reached via her website or at (416) 267-6789.
