Your dental insurance benefits are recalculated on an annual basis. The vast majority of people observe it on January 1st. But if your dental insurance is reset, it also means that the advantages from the previous year no longer apply. To put it another way, you have the option of carrying over an unused or expired insurance policy into the following year. After the expiration date, you will no longer have access to the insurance coverage, and you will only be able to take use of a limited amount of the coverage or benefits that are available to you between January 1 and December 31.
That means that once the page on the calendar is turned, any of your benefits that have been unused will be lost. Therefore, if you were unable to have that second (or first) checkup because of the pandemic in 2021, you will not be able to carry those missed appointments over into 2022.
It Is Important to Practice Preventive Dentistry
Regular visits to the dentist for cleanings and exams are the best way to maintain good dental hygiene. They also provide us with the opportunity to identify possible problems well in advance of those problems developing into major difficulties. The most exciting part? Your dental insurance most likely covers the cost of the best preventive dentistry services in full or very close to it.
When you go in for your checkup every six months, you will often receive preventive treatment. It is intended to improve the degree of dental health you currently possess and detect minor problems while they are still amenable to correction. The following are some examples of preventive services: dental cleanings; fluoride therapy; bite splints or mouth guards; oral cancer screenings; dental sealants for youngsters; periodontal evaluations; routine exams;
If you fall behind on your checkups, this could result in your out-of-date and expired insurance coverage being discarded. Throughout the course of the year, your regular premium payments have served as payment for those services. But you will lose them if you don’t put them to use.
If you want to be sure that your dental insurance is “working” for you, the best thing you can do is to make sure that you schedule your checkups exactly on the dot every six months. Therefore, you will never fall behind on preventative care and will never have to worry about having to pay for treatment out of cash because your insurance coverage has run out.
Utilizing Your Restorative Benefits to Their Full Potential
When it comes to comprehending the extent of your dental insurance coverage, there are numerous treatment categories that fall under a variety of levels or tiers. As medical procedures grow increasingly difficult to carry out, they are promoted to more difficult levels of treatment. These several classifications of medical interventions are each covered at their own individual rates. Therefore, what might be covered at a rate of 75–80 percent if it’s a basic filling could drop to 50 percent if it’s a more extensive restorative surgery.
It is not possible to carry unused benefits over to the following year or to “stack” them with your new benefit allocation in order to pay for more extensive treatments. The coverage provided by the insurance policy that has since lapsed is no longer available. Because of this, it is highly recommended to make use of it while surgical treatments are still very minor and more reasonably priced. You are, in essence, putting your dental insurance to work for you, and as a consequence, you reduce the amount of money that you have to pay out of pocket for your dental care.
Not only are treatments administered sooner more affordable, but they are also less intrusive. Before problems such as decay or disease start to eat away at your smile, we are able to assist you in preserving a greater portion of the natural tooth structure that you have. If you put off getting treatment, eventually the tooth will get to the point where it can’t be saved and it will fall out. At that point, it is typically necessary to eliminate it completely.
“I Am Unaware of the Benefits That My Insurance Provides”
Our dental professionals in Summerlin will do all in their power to explain the benefits and breakdowns of your insurance in a language that is simple and straightforward. You won’t be taken aback by any unexpected costs if you do it this way. You will have access to all of the information that you require in order to actively participate in the planning of therapies. In addition, Dr. Cohan will make every effort to figure it out in such a way that each stage is finished before the end of the year, which is when the advantages of your dental insurance will be exhausted.
If you are unsure of the date of your most recent dental visit, please let us know, and we will check with your insurance provider to see what benefits are still available to you. In our medical practice, we are always happy to see new patients! When you phone to schedule your appointment, just make sure that you have your dental insurance card on hand before you do so. In this manner, we will be able to compile all of the necessary information prior to your arrival. In addition, we are able to inform you if the renewal of your insurance coverage occurs on a date other than January 1st.
Make an Appointment with you Insurance as Soon as Possible
COVID-19 resulted in a severe delay in dental care for an unprecedented number of individuals. To our good fortune, the majority of dental insurance coverage prioritize preventive dentistry as a primary benefit. You can reduce the overall cost of treatment in the future by taking advantage of the normal coverage and preventative services that your insurance plan provides.
But that’s not the end of it. In the event that you do find yourself in need of treatment, it is imperative that you make use of the advantages that are contained in your plan before the 31st of December. Therefore, make sure that you schedule your appointment for preventative dentistry in plenty of time in advance so that you will have enough time to turn around and treat any problems that may have been going untreated up until this point.
Our dentist in Summerlin, Dr. Marianne Cohan, is a firm believer in providing care for dental health that is proactive, preventative, and less intrusive. Make sure to schedule your next visit as far in advance as you can so that we can assist you in maintaining good oral health (and dental care costs low.) Get in touch with Summerlin Dental Solutions right away.
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GET TO KNOW YOUR BEST DENTIST IN SUMMERLIN
Dr. Marianne Cohan was voted The Best Dentist/ Dental Office and Best Cosmetic Dentist from The Las Vegas Review-Journal in 2020 and 2021. She received her Doctor of Dental Surgery (DDS) from the State University of New York at Buffalo in 1992.
With an emphasis on cosmetic dentistry, complete makeovers, and implant dentistry, Dr. Cohan is committed to continuing education and feels that we never stop learning. Dr. Cohan takes pride in using high-powered magnification to perform minimally invasive restorative dentistry. She uses all the latest technological advances including digital radiography, digital photography, computer simulations, and high-resolution pictures of your proposed treatment on 55-inch screens. She also utilizes CBCT (cone beam) and laser technology.
Do Dental Insurance Benefits Expire?
Q1: Do my dental insurance benefits really expire at the end of the year?
Yes. Most dental insurance plans have an annual maximum (typically $1,000 to $2,000) that resets on January 1. Any unused benefits from the current year are permanently lost — they do not carry over. Using your remaining benefits before December 31 ensures you get maximum value from the premiums you have already paid.
Q2: What happens to my unused dental benefits?
They disappear. Unlike medical insurance deductibles or HSA funds, dental insurance annual maximums do not roll over. If you have $800 remaining and the year ends, that $800 is gone permanently. The insurance company keeps the premiums regardless of whether you used the benefits.
Q3: How can I maximize my dental insurance before year-end?
Schedule your second annual cleaning if you have not already, complete any recommended treatment that insurance will partially cover, and ask Summerlin Dental Solutions to check your remaining benefits. Our team can calculate exactly what coverage remains and help you use it before the deadline.
Q4: Can I split a treatment plan across two calendar years to use two annual maximums?
Yes, this is a smart strategy that our team at Summerlin Dental Solutions frequently helps patients with. If you need multiple crowns, for example, placing some before December 31 and the rest in January uses two separate annual maximums, effectively doubling your insurance contribution.
Q5: When does my dental insurance deductible reset?
Most deductibles reset on January 1 alongside the annual maximum. If you have already met your deductible this year, completing treatment before year-end means insurance pays a higher percentage. In January, you will need to satisfy the deductible again before coverage kicks in.
Q6: Does Summerlin Dental Solutions help with insurance benefit planning?
Absolutely. Our front office team checks your remaining benefits, calculates the optimal timing for treatment, and helps you develop a plan that maximizes insurance coverage across calendar years. This is a routine service we provide for every patient at no additional charge.
Q7: What if I need expensive treatment but my annual maximum is almost used up?
We can phase treatment to use remaining benefits this year and continue in January with your renewed annual maximum. For any remaining balance, 0% interest financing through HFD is available. Our goal is ensuring cost never prevents you from getting the care you need.
Q8: Are there any dental insurance benefits that do not expire?
Preventive benefits (cleanings, exams, X-rays) renew with each plan year. Orthodontic lifetime maximums are separate from annual maximums. HSA funds roll over if in a qualifying plan. FSA funds generally must be used within the plan year (some plans offer a small grace period).
Q9: How much do most patients lose in unused dental benefits each year?
Industry estimates suggest the average American uses only about half of their dental insurance benefits. With annual maximums of $1,000 to $2,000, that means most people leave $500 to $1,000 on the table every year — money they have already paid for through premiums.
Q10: Should I schedule treatment now or wait until January?
If you have remaining benefits this year, use them before December 31. If your deductible is already met, treatment now gives you the highest insurance coverage percentage. Our team at Summerlin Dental Solutions can advise on the optimal timing for your specific situation.
Dr. Cohan is always available to her patients and is available for any dental emergency.
