Dental Benefits: Use It or Lose It

t’s that time of year again in the dental insurance world: use it or lose it time. According to a recent MouthHealthy.org article, only 2.8% of people with PPO dental plans reached or exceeded their plans annual maximum. Whether you’re paying for dental care through a benefits plan or using a Flexible Spending Account (FSA), it is likely that your benefits will run out on December 31. Before you lose your hard-earned coverage dollars, schedule a visit with your dentist. Here’s a look at what your remaining benefits are, when you need to use them by and how to get the most out of them.

Dental Benefit Plans

Majority of people with dental benefits get them through their employers, however individual plans are also available through Health Insurance Marketplaces. When you buy a plan you (and your employer) are paying some premium, or upfront dollars. When you skip the dentist, you are wasting that money. Several insurance companies have a benefit deadline of December 31, meaning that any of your unused benefits don’t roll over into the next calendar year. Some plans may end at different times, so be sure to check your plan document or ask your employer to double check.

In order to get the most out of your plan, you should aim to take advantage of any benefits before they expire. Since most plans pay 100% for preventive visits, now would be a great time to schedule one. It’s best to discuss future dental needs with your dentist earlier in the year, so that you can schedule the appointments before the end of the year. After determining what treatments are needed, check with your benefits provider to find out what is covered. Your dentist will usually help with this.

Flexible Spending Accounts

An FSA is an account you can set up through your employer. During open enrollment, you select the amount of money you’d like to put into this account, and a portion of this amount is then deducted from each paycheck, pre-tax. FSAs typically cover services or products that help keep your mouth healthy, including cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures and more. Many FSAs work like debit cards, allowing you to use that card to pay for various medical and dental expenses. In general, you must use the money in an FSA within the plan year by December 31. However some may offer one or two options that give you a little more time to spend: a grace period of up to 2.5 extra months to use the money in your FSA, or the ability to carry over up to $500 per year to use in the following year. Either way, you still lose any money that you haven’t spent at the end of the term.

Here are some tips to help make the most of your FSA:

  • Plan ahead so you don’t put more money in your account than you will spend
  • Just like dental benefit plans, talk to your dentist earlier in the year to determine what your dental needs are, and schedule those appointments before the end of the calendar year.
  • Contact your FSA administrator for a list of covered services/eligible expenses.

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