Dental Cover And Benefits: Patient Guide

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Many patients do not maximise the use of their dental benefit or insurance plants. According to the National Association of Dental Plans less than 5% of patients reached or exceeded their plan limits. Many patients also have FSAs or Flexible Savings Accounts which are used to help pay for dental and medical care on a tax free basis.

If you are making payments for your dental care via a benefits plan or FSA most plans run to 31 December each year. In order to maximise your advantages you should not let your allowances be wasted. This article provides information on the range of benefits available, usage dates and making the most of your benefits. Your dentist and local orthodontist will also be able to advise on benefit packages and your treatment options.

Dental benefit packages – many people access dental benefit schemes through their companies, and individual plans are also offered via online marketplaces and policies. When patients buy plans contributions are made into the plan by the patient and employer, and these are wasted if appointments are not attended. Many insurance companies state 31 December as their annual cut off date. Benefits which are not taken are not carried forward into the next financial year for the majority of plans. Some schemes have different dates throughout the year so it depends on your personal plan and the terms offered. You should check with your scheme or employer to confirm the actual date.

Maximising your benefits – the main consideration is to take advantage of benefits before the annual expiry date. As prevention is the best strategy, the majority of plans will pay 100% of the cost of preventive appointments. If you start thinking and planning around your coverage as early as possible, you can schedule appointments and treatment within the plan period. You should discuss with your dentist your dental needs so that you can plan accordingly.

Flexible spending accounts – FSAs are set up via your employer. You can choose how much you want to contribute and a portion is deducted from your pay on a pre-tax basis. FSAs cover a range of treatments, products and services to improve your dental health. This includes cleanings, orthodontics, dentures and a range of other treatments. Some FSAs provide a debit card which can be used to pay for medical and dental treatment expenses and some products available ad your local drug store. FSA funds will also generally need to be used by December 31 each year. Employers may extend this period or allow you to carry some funds forward. Make sure you do not lose money that has not been used.

To make the most of your FSA you should plan carefully so that you do not add more funds than you plan to spend. You should talk with your dentist over the summer months to see if you need any treatment procedures that could be completed before year end. Your FSA administrator can also provide a list of covered treatments, products and services. This list is referred to as an eligible expenses list. Most FSAs cannot be used for cosmetic dentistry treatments such as tooth whitening, veneers or cosmetic braces. You should book any required appointments ahead of the expiry date to maximise your benefits.

Categories: Dental