Make the Most of Your Dental Benefits Before Year-End

Every fall, the same thing happens in our office. Patients call in December hoping to squeeze in treatment before their benefits reset, and by then the calendar is full. If you have dental insurance or a health savings account, the next couple of months are the best time to look at what you have left and put it to work.

Why Year-End Matters for Dental Benefits

Most dental insurance plans run on the calendar year. On January 1, your benefits reset, and in most plans any unused annual maximum is simply gone. You have paid premiums all year for that coverage, so leaving it on the table means paying for care you never received.

Three things usually reset at the same time:

• Your annual maximum. This is the most your plan will pay toward your care in a year. Whatever you do not use typically does not roll over.
• Your deductible. If you have already met it this year, treatment done now may cost you less out of pocket than the same treatment in January, when the deductible starts over.
• Your preventive visits. Many plans cover two cleanings and exams a year. If you have only had one, the second may already be paid for.

Not every plan works this way. Some run on a different plan year, and a few allow part of the maximum to roll over. Your plan documents, or our insurance coordinators, can tell you exactly how yours works.

Don't Forget Your FSA or HSA

If you have a Flexible Spending Account (FSA) through your employer, check your balance now. FSA funds are generally "use it or lose it." Depending on your employer's plan, you may have a short grace period or be able to carry over a limited amount, but anything beyond that is forfeited. The IRS explains how FSAs, HSAs and their carryover rules work in more detail.

A Health Savings Account (HSA) is different: the money stays yours and rolls over year to year. Even so, it can be a smart way to pay for treatment you have been putting off with pre-tax dollars.

Both can usually be used for qualified dental care, including periodontal treatment and dental implants.

Treatments Worth Scheduling Before Year-End

Your cleaning and exam. If you are due for a visit, getting it in before December 31 uses coverage you have already paid for. For patients with a history of gum disease, periodontal maintenance visits every three or four months help keep the disease under control, and those visits count toward this year's benefits too.

Gum disease treatment. If you have been told you have deep pockets or bleeding gums, scaling and root planing is often partially covered. Treating gum disease sooner also protects the bone that supports your teeth, so waiting rarely makes it cheaper.

Gum recession treatment. If a tooth has started to look longer or feels sensitive to cold, now is a good time to have it evaluated. Read our guide to gum recession treatment to see how gum grafting and the Chao Pinhole technique compare.

The first phase of a dental implant. Implant treatment usually happens in stages over several months, such as an extraction or bone graft first, then the implant, then the final tooth. Starting now lets one phase fall under this year's benefits and the next phase under next year's, which can make a bigger treatment plan much more manageable.

How to Check What You Have Left

You do not have to figure this out on your own. A few simple steps:

1. Log in to your insurance carrier's website or call the member number on your card and ask for your remaining annual maximum and deductible.
2. Check your FSA or HSA balance through your employer or benefits provider.
3. Call our office. Our insurance coordinators work with many different insurance companies every day, and they can help you understand your benefits and submit your claims.

Coverage varies by plan, and some procedures are covered differently than others, so we always recommend reviewing your options with our team before treatment.

Flexible Ways to Pay

If your benefits do not cover everything, you still have options. We accept cash, checks and major credit cards, and offer financing and extended payment plans through CareCredit, Fifth Third Bank and Affirm. You can find the details on our financial policy page.

Book Before the Holiday Rush

Appointments fill up quickly in November and December as patients rush to use their benefits. Booking now gives you the best choice of times and leaves room to finish treatment before the year ends.

Call our Daytona Beach office at (386) 258-2213 or our Palm Coast office at (386) 447-5846, or request an appointment online. We will help you make the most of the benefits you already have.