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Schedule With a Dentist in Redmond So You Don’t Lose Your Benefits!

October 19, 2018

Filed under: Uncategorized — Dr. Steve Schwam @ 5:43 pm

A dental insurance claimIt’s always frustrating when you realize that you’ve missed out on a financial opportunity. And while you may not think about your dental insurance that way, that’s exactly what happens when you forget to schedule with a dentist in Redmond before the end of the year. Whether you need a routine checkup or more extensive dental work, the money your insurance company is willing to pay for your dental care is a lot like “free money.” In fact, the American Dental Association estimates that the average annual insurance benefit is $1,250 per person, but most people only get around $323 of dental work annually. Since those benefits are lost at the end of the year, that’s over $900 that many people are passing up. Keep reading below for tips on how to take advantage of your benefits and make sure you don’t miss out this year!

Which Procedures Will Your Insurance Cover?

It’s always important to check your individual benefits, since there are hundreds of insurance plans that each provide different coverage. Having said that, here are some common percentages for several procedures:

  • Cleanings, X-Rays and Exams – Checkups are preventative, so they’re usually covered at 100%. Most plans will cover 2 checkups per year, although 3-4 may be covered during pregnancy or for patients who have gum disease, diabetes or cancer. In addition, your plan might cover professional fluoride treatments (which are excellent for cavity prevention), so it’s a good idea to check your benefits or ask the front desk staff at your dentist’s office.
  • Deep Cleanings – Recommended for patients with gum disease, deep cleanings are usually covered at 60%-80%.
  • Fillings and Root Canals – Many plans will cover 60%-80% of the cost of fillings and root canals.
  • Crowns and Bridges – Crown and bridgework is typically covered at 50% – 70%.

What Can You Do To Maximize Your Benefits?

The first step is to double check when your plan starts and ends. Some plans begin and end on a fiscal year, but most start January 1st and end December 31st.

Since dental schedules fill up quickly towards the end of the year, it’s important to schedule any appointments as soon as possible. In particular, since preventive care is usually covered at 100% and won’t cost you a dime, everyone should be scheduling their routine checkups and preventive care!

If you need more extensive dental work, start by finding out what your deductible is to get a better idea of your total cost. It’s also helpful to ask your dentist to file a preauthorization beforehand. This formal estimate from your insurance company will give you a breakdown of the coverage they’ll provide.

Finally, don’t forget that most plans have an annual maximum (usually $1,000-$3,000), which is the total amount they’ll pay for your dental work each year.

You may as well take advantage of this “free money” to help you achieve or maintain a healthy smile. Otherwise, you’ll lose your annual benefits and let a great financial opportunity pass you by!

About the Author

Dr. Steve Schwam is a general, cosmetic and restorative dentist in Redmond who wants to make it possible for all his patients to get the dental care they need. That’s why he and his staff encourage everyone to maximize their benefits and do everything they can to help patients navigate their insurance plans. If you have any additional questions about your benefits, he can be contacted via his website or at (541) 526-5661.

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