How to Maximize Your Dental Benefits Before the Year Ends & Other Insurance FAQs
As the end of the year approaches, it's time to take a closer look at your dental insurance benefits and health savings accounts (HSAs). Dental health is an integral part of your overall well-being, and making the most of your dental insurance coverage is a smart decision for both your oral health and your wallet. In this post, we'll answer some general insurance FAQs and help you understand how to maximize your benefits at Mayfield Smiles before the year is over!
Insurance Key Terms
Understanding dental insurance involves familiarizing yourself with key terms that define the terms and conditions of coverage. Whether you’re new to having dental insurance or just need a quick refresher, here are some key concepts to be aware of.
Premiums: You (or your employer) pay a monthly or annual premium to the insurance company to maintain coverage.
Coverage Types: Dental insurance plans often cover a variety of dental services, including preventive care, basic procedures, and major procedures. The specifics of coverage can vary widely between plans.
Deductibles: Some dental insurance plans have a deductible, which is the amount you must pay out of pocket for covered services before the insurance starts to contribute.
Co-payments or Coinsurance: After you've met your deductible, you may still be responsible for a percentage of the costs. This is often called coinsurance, and it's a percentage of the total cost that you must pay, with the insurance covering the rest. Alternatively, there may be fixed co-payments for specific services.
Annual Maximum: Many dental insurance plans have an annual maximum benefit, which is the maximum amount the insurance company will pay for covered services in a given year. Once you reach this limit, you are responsible for all additional costs.
Networks: Dental insurance plans often have a network of dentists with whom they have negotiated lower rates. Going to an in-network provider may be less expensive for you, and some plans may not cover any costs for out-of-network providers.
Preventive Care: Dental insurance plans typically place a strong emphasis on preventive care, such as regular cleanings and check-ups. Many plans cover preventive services at a high percentage or even at 100%, encouraging policyholders to maintain good oral health.
Waiting Periods: Some dental insurance plans have waiting periods before certain services are covered. This means that you may need to wait for a certain period after enrolling in the plan before you can receive coverage for specific procedures.
What Does Dental Insurance Cover?
Dental insurance typically covers a range of preventive and restorative treatments to maintain your oral health. These commonly include:
Preventive Care: Regular check-ups, cleanings, and X-rays.
Basic Procedures: Fillings, extractions, and root canals.
Major Procedures: Crowns, bridges, and dentures.
Please note that cosmetic services, such as veneers or teeth whitening, are not covered by HSAs at Mayfield Smiles.
Also, keep in mind that the specifics of your dental insurance plan may vary. You can refer to your plan documents or contact your insurance provider to learn about your coverage in detail. Contact Mayfield Smiles to inquire about the services we provide and whether we accept your insurance.
Can I Use My Benefits at Any Time?
Most dental insurance plans have an annual benefit maximum, which is the maximum dollar amount your insurance will pay toward your dental care in a calendar year. If you don't use your benefits by the end of the year, they typically don't roll over to the next year. That means now is the time to schedule any necessary treatments to make the most of your coverage.
Which Insurances Are Accepted at Mayfield Smiles?
At Mayfield Smiles, we understand the importance of affordable and accessible dental care. We accept a wide range of dental insurance plans to ensure our patients can benefit from their coverage. Though this list is not exhaustive, some of the commonly accepted dental insurances include:
Delta
Cigna
Connection Dental Network - This is an umbrella network that consists of many insurance plans and providers.
Careington Dental Network - This is an umbrella network that consists of many insurance plans and providers.
If you're unsure whether your insurance is accepted, feel free to contact our office and our team will be happy to assist you!
How Can I Maximize My Dental Benefits?
To help use your dental benefits before the year ends, consider the following tips:
Schedule your regular check-up and cleaning appointments if you haven't already done so. We tend to get busy around the holidays, so don’t wait!
Address any existing dental issues to prevent them from worsening and requiring more extensive, costly treatments.
If you need major dental work, such as crowns or bridges, plan to complete them before the end of the year to make the most of your annual maximum benefit.
Utilize any remaining flexible spending account (FSA) or health savings account (HSA) funds for dental treatments.
Consult Mayfield Smiles and your insurance provider to fully understand your coverage and make informed decisions.
If you have any questions about your insurance coverage or would like to schedule an appointment at Mayfield Smiles, please don't hesitate to reach out to us. We are here to help you make the most of your dental benefits and keep your smile in top condition.
