If you have dental insurance through work or a private plan, you may be leaving money on the table. Many dental plans run on the calendar year, which means some of your benefits reset on January 1, and whatever you haven’t used is gone. Here’s how dental benefits work and how to get the most from yours.
How dental benefits usually work
- Annual maximum. Most plans pay up to a set dollar amount per year. Unused benefits generally do not carry over to the next year.
- Deductible. Many plans have a deductible you pay before the plan starts covering certain services. It usually starts over when your plan year renews.
- Preventive visits. Many plans cover routine exams and cleanings, often twice a year, at little or no cost to you. If you haven’t had both visits this year, you may still have one available.
Not every plan follows the calendar year, and every plan is different. Check your benefit booklet or call your insurance company to confirm when your plan year ends, how much of your annual maximum is left, and whether your deductible has been met. Our team is also happy to help you look into your benefits.
Have a flexible spending account (FSA)?
If you set aside money in a flexible spending account (FSA), it can usually be used for dental care. FSA funds are often “use it or lose it” by the end of the plan year, although some employer plans offer a short grace period or let you carry over a limited amount. Check your employer’s rules so those dollars don’t go to waste. Health savings account (HSA) funds, by contrast, roll over from year to year.
Why it pays not to wait
Dental problems rarely get better on their own. A small cavity that could be fixed with a simple filling can grow until the tooth needs a root canal or a crown. Early gum disease that responds to a deep cleaning can progress to bone and tooth loss. Treating problems early is usually easier, faster, and less expensive.
If you have treatment that your dentist has already recommended, scheduling it before your benefits reset lets you use this year’s coverage. If your treatment plan is larger, your dentist may be able to split it between this year and next so you can use two years of benefits. Ask us what makes sense for you.
Bring your insurance information
We work with most insurance companies and work with you to maximize your reimbursement for covered procedures. Please bring your insurance card and member ID number to your appointment. A valid ID number is needed before treatment can begin, unless other payment arrangements have been made.
A few things to know about how billing works:
- Most insurance companies respond to claims within four to six weeks.
- Any balance remaining after your insurance pays is your responsibility.
- Payment is due at the time of service unless other arrangements have been made in advance. Monthly payment plans must be arranged before the procedure.
See our insurance information, financial policy, and financing and payment plans for details.
Have Illinois Medicaid or All Kids?
Medicaid dental coverage works differently from private insurance, but it still includes regular checkups: typically every six months for children and every 12 months for adults. If it has been a while, it’s a good time to book. We welcome kids and adults with Illinois Medicaid at both offices.
Book before the year runs out
Call our Downers Grove office at (630) 884-8174 or our Aurora office at (630) 884-8194, or request an appointment online. New patients can save time by filling out their forms online before the visit.