Your Dental Benefits: What You Need to Know

According to the American Dental Association (ADA), millions of people are leaving money on the table each year when it comes to their dental benefit plans. In fact, the National Association of Dental Plans reports that only 2.8% of people with a PPO dental plan reached or exceeded their plan’s annual maximum. And while many people use Flexible Spending Accounts, these too will likely run out each year on December 31st.

In short, we here at Boulevard Dental Associates don’t want your hard-earned dollars to go to waste. That is why we have provided a summary of the helpful information provided by the ADA, educating you on your dental benefits and how to make the most of them.

Dental Benefit Plans

Benefit plans are available through employers or via individual plans. Either way, you or your employer pay a premium, or money paid upfront. This premium will be wasted if you don’t go to see your dentist.

When You Need to Use Them By

Many insurance companies have a benefit deadline of December 31st. This means is that unused benefits won’t roll over into the New Year. That said, some plans may end at different times of the year, so it is important that you check your plan document or ask your employer about your specific plan deadline.

Tips for Making the Most of Your Plan

  • Schedule your preventative visits. Prevention is a better cure both for your health, as well as for your finances. Many plans pay 100% for preventive visits, so if in this New Year, you have not yet scheduled your preventative visit, it would be wise to do so.
  • Think about using your coverage early. Talk to your dentist about what your dental needs are and what treatment you might need before the end of this year, for instance, in the summer or fall. Also, try to schedule your appointments before the busy holidays.
  • Work with your dentist and benefits provider to figure out what is covered. Often, your dentist’s office will look into this information for you. You can also call your plan, or go to their website for information.

Flexible Spending Accounts

A Flexible Spending Account (FSA) is an account you can set up through your employer. You choose how much money to put into this account, and a portion of this amount is deducted pre-tax from each paycheck. FSAs usually cover services or products that help keep your mouth healthy, such as cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures and more. In addition, many FSAs function like debit cards, which you can use for various medical and dental expenses, including some items available at drugstores.

When You Need to Use Them By

You usually need to use the money in an FSA within the plan year by December 31st. However, your employer may offer one of two options that allow for more time to spend the money in your FSA account.

  • A grace period of up to 2½ extra months
  • A $500 carry over to use in the following year

Check with your employer or FSA administrator to see what your plan allows so you don’t lose money that you haven’t spent.

Tips for Making the Most of Your FSA

  • Plan carefully so you don’t put more money in your account than you will spend within a year.
  • Talk with your dentist in the summer or fall to see if you have any procedures that need to be completed by the New Year. You may also be able to use your FSA to pay for associated co-pays or co-insurance.
  • Contact your FSA administrator for a list of covered services and products (usually referred to as eligible expenses). However, most FSA accounts cannot be used for cosmetic procedures such as whitening, veneers or cosmetic braces.
  • Make any remaining dental appointments as soon as you know you need them in order to use your FSA dollars on time.

At Boulevard Dental Associates, we care about you…and your dental benefits!


Source: ADA – American Dental Association