2421 Ford St, Golden, CO 80401

Maximizing dental benefits and using remaining benefits



purse 1766945c

Understand your plan:

Be sure to review the booklet given to you by your insurer that contains all the information about your coverage. Insurers also usually offer easy to understand benefit summaries online. We understand that maximums, deductibles and out of pockets percentages can be confusing. Be proactive in getting answers about your dental insurance so that you can both anticipate costs and use benefits before they are gone.

Choosing the right dentist or orthodontist for your plan:

PPO, DMO or HMO can again be confusing. Choosing a dentist that is in network with your plan is key to maximizing or even being able to use your dental insurance. HMO and DMO's require selection of one primary network dentist. Being in network means the dentist has agreed to in network fees and this means that your percentage out of pocket or co payment is less because the fee is less compared to an out of network provider. Some dental plans have multiple networks and their dentists may participate in all or only some of them. Before scheduling as a new patient or scheduling after an insurance change, make sure to contact the provider to verify that they are in network with your plan.

Take advantage of benefits:

Diagnostic and preventative dentistry are usually covered by your insurer at 80% to 100% and for PPO plans, the deductible is waived for most of these D&P procedures too.  Make sure you and your family schedule allowable cleanings, exams and x rays when due. Procedures like sealants for children are also considered preventative and  a great way to prevent chewing surface cavities. Dental problems get worse when not diagnosed or when not treated. Delaying treatment means more extensive work that will need to be done in the future and this means more cost. 

Use it or lose it:

Your dental plan gives you and the members of your family an annual maximum of what can be spent on dental care. These maximums are typically reset at the end of the year, and if you have unused benefits, they will be forfeited. When your plan rolls over, you are required to pay your deductible again before you can start taking advantage of benefits once again. If you have work that needs to be done and have met your deductible, don't put it off...schedule it. Another reason to use your benefits now is because it is always possible that fees will be raised in the new year. An increase in fees can also raise your co pay.