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Dental Insurance and FSA ... Use It or Lose It!


Dental Insurance and FSA ... Use It or Lose It!

Did you know that dental insurance benefits do not roll over from year to year?

Millions of people in the US leave unused dental benefits on the table each year. The National Association of Dental Plans estimates that only 2.8% of people with PPO plans reach their plan's annual maximum. Additionally, many people now have FSAs (Flexible Spending Accounts) which can help pay for their dental care. These type of plans often "run out" on December 31st as well. Here's how we suggest you make the most of any remaining benefits you might have ...

Traditional Dental Insurance 

Many people with dental benefits get them through their employers, though individual plans are also available through Health Insurance Marketplaces established by the Affordable Care Act. Remember, when you buy a plan you and your employer are paying some premium – upfront dollars – that are wasted if you don’t see your dentist.

When You Need to Use Them By

Many insurance companies have a benefit deadline of December 31, and this means that any of your unused benefits don’t roll over into the New Year for most dental plans. Still, some plans may end at different times of the year, so check your plan document or ask your employer to be sure. 

Tips for Making the Most of Your Plan

The key with this type of coverage is to take advantage of any benefits before they expire for the year.

  • Prevention is better than treatment both for your health as well as your pocketbook. Most plans typically pay 100% for preventive visits, so if you’re duet, this is a good time to schedule one.

  • Start thinking about using your coverage early. During a dental appointment this fall, talk to Dr. Kivel about what your dental needs are and what treatment you might need before the end of the year. Make any upcoming appointments early so you can take care of them before the holidays.

  • Once you've determined what your dental needs are, you can work with our front office coordinator or your insurance company directly to figure out what is covered. You can call your plan using the 800 telephone number on your identification card, or usually go to their website for information.


Flexible Spending Accounts

A Flexible Spending Account (FSA) is an account you can set up for healthcare costs. During open enrollment, you choose how much money to put into this account, and a portion of this amount is deducted from each paycheck pre-tax. FSAs generally cover services or products that help keep your mouth healthy, including cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures and more. This huge benefit of this account is spending money that has not been taxed on your health expenses.

Many FSAs work like debit cards, and you can use that card to pay for various medical and dental expenses, including some products available at your local drugstore. 

When You Need to Use Them By

Generally, you must use the money in an FSA within the plan year by December 31. However, your plan may offer one of two options that give you a little more time to spend what’s in your account:

  • Some provide a grace period of up to 2½ extra months to use the money in your FSA.

  • Others may allow you to carry over up to $500 per year to use in the following year.

Whether it’s at the end of the year or a grace period, you lose any money you haven’t spent. Check with your employer or FSA administrator to see what your plan allows.

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 on dental or other health care costs.

  • As with dental benefit plans, talk with Soulsmile this fall during regular appointments to see if you have any needs or procedures that need to be completed. You may be able to use your FSA to pay for these needs or use your FSA to pay any 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 and services like whitening, veneers or cosmetic braces.

  • Make any remaining dental appointments as soon as you know you need them to ensure your FSA dollars can be used in time.

Have any questions regarding your own insurance plan, coverage or treatment needs? Call us at 541-482-4995 and we’ll be happy to help!


Maximize Your Dental Benefits Before January


Maximize Your Dental Benefits Before January

The end of the year is quickly approaching and with it, the end of another dental insurance benefit year. You're probably thinking more about stuffing and cranberries than dental benefits, but we'd recommend putting aside a bit of time in between your holiday plans to make sure you are maximizing benefits which will be lost as of January 1st. 

1. Don't Throw Away Money,!

Going into a new year with unused benefits is like tossing hard earned dollars you worked for all year. If you're like a majority of people, your insurance plan expires each calendar year. Unfortunately, your remaining benefits do NOT rollover - they expire! Trust us, your insurance company won't remind you of this. In fact, they bank on millions of Americans overlooking this and benefiting them instead of you. 

2. Find Out About Your Annual Maximum 

Each year, your insurance plan sets an annual maximum of dental work they will pay for. This is called the annual maximum. Each plan is different, but this amount is usually $1000-2500. You'll also want to find out how much you've already used this year (if you're a Soulsmile patient here in Ashland, call us - we can tell you!).

3. Consider Pending Treatment 

You may already have a tooth that's nagging at the back of your mind and you know needs to be fixed. Other times, patients may forget about treatment that is not a huge priority (like preventatively replacing old amalgam fillings that are prone to leaking). Give us a call or come in for an exam if you'd like to find out if you have any pending treatment we can put towards your benefits. 

If you have any questions, please call us at 541-482-4995. You can also call your insurance provider directly for more details regarding your unique plan. Our end-of-the-year schedule fills up quickly, so call us today to use up your benefits before its too late!