Yearly Dental Insurance Benefits: Use It or Lose It

The holidays are right around the corner, they’ll be here, done, and over with before you know it. Getting ready to wrap up the year may already have your mind full, but have you stopped to consider your dental insurance benefits runing out of time, too?

How Annual Dental Insurance Works

Dental insurance benefits are available through most employers and the cost of the premium is automatically deducted from your payroll check every month. Not all policies are the same but the majority of them work by providing you with a certain amount that they’ll pay per year for your dental care.

Yearly Allowance

Typically, dental policies will cover around $1,000 to $1,500, though some plans do offer a higher allowance.


Cleanings (Prophy)

Cleanings, as long as there’s no gum disease involved, are usually paid for in full out of your maximum allowance, and available twice per year. So even if you’re one of those people who dread having dental work done, you could at least come in for your preventative care cleanings, and not have to pay out of pocket. The extra checkups can actually cut down on how much treatment you need in the future!

Dental Work

If you need to have any dental work done, like a filling, or a crown, your policy may pay for a certain percentage of these procedures.  There will be a one-time deductible that you have to pay every year (which is usually about $50 or $75, or $100 for some policies.)  Once you’ve taken care of that portion you can expect your plan to pay about 80% of the cost of your filling or crown or about 50% of root canal therapy. Again, payment is only made up the yearly allowable amount and based on the plan specifics that you have.

How Long Are Benefits Effective For?

When the calendar year ends, if you haven’t used all of your insurance benefits then you lose them for good.  Most policies don’t rollover.

For this reason, towards the end of every year, we like to remind our patients that they should get in to have their dental work completed and use up the benefits that they’re entitled to (before they lose them altogether.)

Why Now?

You may be thinking that you still have plenty of time to use up your yearly benefits, but you should consider the fact that it may take several days or even a few weeks before there is an available appointment for a specific procedure.  Also, some dental treatments, like an implant, require several appointments that are spread throughout the span of several months.

Having your dental work done is also a great way to utilize the remaining balance of your flexible spending account (FSA) or healthcare spending account (HSA). Using these funds along with your dental insurance can keep you from making any out of pocket payments!

Getting the Most of Out Your Dental Insurance Benefits

If you need help understanding your insurance benefits and want to make sure that you’re getting the most of your policy, then call the offices of North Houston Dentistry.  We’re serve the North Houston areas and Dr. Bastani would be happy to walk you through your individual coverage. Call to speak with our insurance coordinator today.