Dental Benefits and The New Year: Use Them or Lose Them

Little kid at dentist

Fall is here! And that means it won’t be long before we are ushering in the new year. 

The end of the year means setting goals, new beginnings, and fresh starts for many people. But while making to-do lists and big plans for celebrations and resolutions, there’s one thing that many people forget to do at the end of the year — use their dental benefits. 

Many dental insurance plans are on a calendar year and have strict “use it or lost it” rules. This means that if you haven’t used your dental benefits by December 31st, 2019, you’ll lose them. These are benefits you’ve been paying for all year as you’ve made your insurance payments, why would you want to them slip out of your grasp? 

It seems like an obvious waste but millions of dollars in potential dental insurance benefits are lost across the U.S. every year because patients don’t use them in time. 

We don’t want you to lose money. As we approach the end of the year, here’s a quick rundown on what you should know about your insurance and some ways you can avoid losing the benefits you’ve already paid for.  


Don’t get confused by your policy. Here are some terms that will be especially helpful to know as the end of the year approaches. 

Deductible: A deductible is the amount you have to pay out of pocket for healthcare before your insurance begins paying for covered services. If you’ve hit your deductible, that means you’ve paid your share for services and your insurance will now start covering certain procedures and costs. Deductibles vary by plan so it’s a good idea to check your plan and your progress. 

Annual Maximum: After your hit your deductible, you start working toward your annual maximum, this is the dollar amount that a plan will cover in a year. This number also resets in the new year so if you haven’t met it, you’ll lose the difference when the clock strikes midnight. 

If you’ve met your deductible but not your maximum, it’s time to start exploring what treatments you might need. 

Pre-Existing Conditions: Pre-existing conditions are conditions you may have had before you signed for your plan that won’t be covered by your insurance. As an example, if you were missing a tooth before your got your dental insurance, many insurance companies will see this as a pre-existing condition and won’t cover the cost of getting it replaced even if you’ve met your deductible. It’s good to know what might count as a pre-existing condition before you start scheduling your end of the year appointments. 

Preventative Care

You should get your teeth cleaned every 6 months so if it’s been a while since you’ve seen a dentist, now is a great time to make an appointment. Most cleanings are covered by dental insurance plans and consistent care is the best way to make sure your teeth stay in tip-top shape. 

Smiling mother and her little son visiting dentist

If you’re paying your premiums every month, you are essentially paying for access to these types of treatments. Even if you’re not experiencing pain or discomfort, regular cleanings can help detect and prevent cavities, gum disease, oral cancer, and other potential dental problems. 

Large Treatments

Got a pain in a tooth that feels like it might need more than a filling? Now is a great time to get it checked out and start the ball rolling on any large procedures like root canals. If you need extensive dental treatments that could involve multiple visits, the end of the year is the perfect time to get started. This is especially true is you’ve already met your deductible but haven’t hit your maximum. 

Once your deductible is met, your out-of-pocket expenses will decrease making it a good time to look into those big treatments. Since many plans have a maximum amount they’ll cover, it’s a good idea to work with your dentist to space out your treatments in order to maximize your coverage. If you’re close to your maximum but haven’t used all your benefits, it might be in your best interest to start the procedure at the end of the year and carry it over into the next. 

Think your child may need braces? The end of the year is a great time to start that process if you have benefits that may go unused. 

Little kid at dentist

According to the National Association of Dental Plans, only 2.8% of people with PPOs meet or exceed their annual deductible amount. This means that many patients are leaving money on the table. Not only that, but any unused benefits at the end of the year may increase your deductible in the next calendar year. 

If you’re not sure what type of calendar your plan is on (fiscal vs calendar) call your insurance provider to find out. They’ll also be able to answer any questions about pre-existing conditions, your deductibles, and your maximums. If you haven’t spent a lot of time studying your plan, the end of the year is a great time to make sure you know what’s covered and what’s not. 

Unsure of what treatments you need, if any? We’re always happy to answer questions about your dental needs. Give us a call today to set up an appointment or check on the status of your insurance. Don’t lose the benefits you’ve already paid for, set up your appointment today. 

For more information on oral hygiene at all ages, contact our Lansing dentists or call us at 517.485.3444.

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