If you have unused benefits as part of your plan’s ‘yearly maximum,’ the answer is, ‘yes!’ A yearly maximum is essentially the most money that a dental insurance plan will pay for your dental work within a single year. Yearly maximums will typically vary between $1,000, $1,500 and $2,000 per year.
So, if you have some unused benefit amount yes – you can, and should, use it.
What Happens to Benefits That I Don’t Use?
Simply, you lose them! Most dental plans run on a calendar year and have a requirement that you have to use your benefits by December 31st each year or you lose them. In other words, any unused portion doesn’t carry over to the next year. For example, if you have a $2,000 benefit and you only use $1,000 of it this year, you lose $1,000 of available benefit. That ‘extra’ $1,000 available benefit doesn’t add to next year’s benefit of $2,000. Next year, on January 1st, you’ll begin with the same $2,000 benefit you had this year – not $3,000. You either use all the benefit each year or you lose it!
Why Should I Use My Remaining Benefits Now?
You should use any remaining insurance benefits prior to December 31st each year to get the maximum value from your coverage. If your dentist has recommended work earlier in the year, and you have unused benefits, now is the time to capitalize on it before time runs out in December.
Let’s look at four reasons not to let your insurance benefits go to waste:
- Value
- Deductibles
- Problem Avoidance
- Fee Increases
First of all, you’re paying for benefits whether you use them or not so, why let money go to waste? You either have insurance through an employer-paid plan or a plan that you have individually. In either case, premiums are paid in return for coverage, i.e., insurance benefits. Anytime you leave unused benefits on the table you’re choosing to let money go to waste. Quite simply, you’re not getting everything you paid for.
Second, your deductible is another reason to use your remaining benefits now. A ‘deductible’ is the out-of-pocket money you have to pay first before your insurance carrier will pay for services. Usually, dental plan deductibles are around $50 – $100 per year. However, your deductible, like your yearly maximum, resets each year on January 1st. (see example below)
Third, putting off a corrective measure now could end up being more costly and involved going forward. It’s quite common, for example, that postponing fixing a cavity now creates the need for a root canal or an implant in the future. Using insurance benefits for either preventative or corrective procedures not only makes sound economic sense but, it’s good oral health decision-making, too.
And, fourth, no one knows what the future holds. Inflation in the form of cost-of-living escalation, equipment price increases, materials supplies, etc. can all contribute to increased dental costs. In that event, your dentist may not have a choice but to increase his or her fees to offset what they’re having to pay for supplies, rent, building mortgage, equipment, etc.
EXAMPLE:
Let’s say that you have a plan with a yearly maximum of $1,000 per year. Let’s also say that you’ve only used $500 of it this year, and that you’ve also met your $100 deductible. So, you have $500 available benefit to use before December 31st of this year. In this example, you can still have $500 of dental work done this year, at no cost to you, because you’ve met your deductible and still have unused benefits. If you wait until January 1st of next year, or later, you lose the $500 you didn’t spend this year plus, you now have to pay another $100 out-of-pocket (deductible) before the insurance company will pay anything. You also might run into more extensive dental needs that exceed your $1,000 yearly maximum (because you put off needed work), and you might even be facing a fee increase from your dentist due to escalating costs from inflation. Not to mention, but we will, insurance premiums and copays could also change in the subsequent year.
Farragut and Knoxville’s Cosmetic Dentist
As a cosmetic dentist we have the ability to care for our family and restorative patients on a very comprehensive level. Given that cosmetic dentistry provides complete oral health care with an emphasis on preventive and maintenance measures, corrects oral imperfections, and helps to enhance a patient’s overall facial esthetics, we’re extremely detail-oriented and meticulous regarding the caliber of our work and the care we extend to each and every patient.
If there’s anything we can do to help you or your family, whether it’s cosmetic (such as whitening, veneers, implants, bonding or more), family, or restorative in nature, please contact us here.
