Q: Hey Doc, I need some crowns, fillings and other work done but the holidays are coming up and I don’t want to spend all my money on myself. I haven’t used my dental insurance this year. What are my options and how do I know what I should do first?
A: Well, this time of year is a particularly good time to have dental treatments done. The reason is many dental insurance benefits terminate at the end of a calendar year and renew at the beginning of the next year. Since I do not know what type of insurance plan you have, I’m going to answer your question based upon the most common scenario.
Most traditional insurance plans have a maximum benefit available per year. It is generally between $1,000 and $1,500. In order to maximize the available benefits, you can plan to have some of your treatment done this year and then wait to do the less urgent treatment once your benefits renew after the first of the year. That being said, it is very important to find out if you have met your deductible and or if your plan has any waiting periods, exclusions or a missing tooth clause.
It’s also a good idea to find out what they cover and what they don’t. Most dental insurance companies do not provide benefits for every procedure done in a dental office. For example, if you want nice white teeth for the holidays or you want to replace missing teeth with implants you will probably be disappointed. Your dental office should be able to help you determine what is covered.
Also, I would consult with your dentist to determine the most urgent areas of need and plan to have those treated first. In many cases, people choose to start with small, simple fillings when larger more invasive problems should be treated first. This lessens the cost to the patient in the long run because small problems take time to grow into larger ones where big problems can worsen in a much shorter period of time.
Your dentist should be able to tell you the amount of your co-payment. If this isn’t financially possible, you may check with your dentist to see if there are treatment alternatives available. This may not be the best scenario but it can allow you to plan for more comprehensive treatment when you are financially prepared.
I hope that this has proven helpful and please keep those questions coming. To everyone I wish you a very Happy Hanukkah and a very Merry Christmas