If you have dental insurance, you may be wondering how you can maximize your benefits and minimize your out-of-pocket costs in the New Year. St. Clair Tooth Co. is here with some quick tips and information that help you make the most out of your dental insurance.
Almost all dental plans include free preventive care, including two teeth cleanings and oral exams each year. Yearly x-rays are also typically included in this cost. This means that you’re only seeing the dentist once a year, you’re leaving money on the table.
Not only that, but you may have a higher risk of gum disease, cavities, and other such oral health issues. Your appointments at St. Clair Tooth Co. will be provided at no cost to you, so it’s important to see Dr. Cassleman twice a year to make the most of your benefits.
Most dental plans use the 100-80-50 model. This means 100% of preventive care is covered, while 80% of basic treatments like fillings and root canals are covered. 50% of the cost of “major” procedures like crowns, bridges, and dentures are covered.
Basically, the more serious your oral health issues are, the less your insurance will pay toward treatment. By getting preventive and routine dental care, you can save yourself from the burden of out-of-pocket costs for dental treatment.
Dental deductibles are usually around $50, but can be up to $250 or more. This is the amount you must pay toward your dental care before your benefits kick in. This resets on January 1st every year.
So if you are getting dental care like fillings, it’s a good idea to make sure that you meet your deductible. For example, if you need a filling and your child also needs a few fillings, scheduling them before the end of the year may be a good idea, since you will likely hit your deductible and pay lower out-of-pocket costs.
Your yearly maximum or “maximum annual benefit” is the maximum amount that your dental insurance plan will pay out toward your dental care, and is usually between $1,000 to $1,500.
If you exceed this amount, you’ll need to pay for the rest of your care out of pocket. But if you do need extensive dental work, it’s a good idea to get as close to the maximum as possible each year, or to exceed it. This means you’ll be making the most of your benefits.
Since this also resets each year, you may also be able to split up treatments to make sure you don’t exceed your maximum, such as getting a few crowns in December, then scheduling other treatments for January of the next year.
If you’re overdue for a preventive appointment or need other dental care in St. Clair Shores or Grosse Pointe, Dr. Carly Cassleman is here to help. We accept all major dental insurance policies, and can help you get the most from your policy. Contact us online or give us a call at (586) 404-4911 to get started right away.