Many patients procrastinate their dental treatments, so it may sound awful to you when a dental staff advises you about maximizing your dental insurance coverage. You probably think that the dentist is trying to maximize his benefits from your insurance. However, when it comes to dental health insurance, utilizing your dental insurance wisely can save you money and maximize your oral wellness at the same time. It can have a significant impact on your life.

All dental insurance policies are different for each individual. Some have more extensive coverage than others. Some have more conditions and restrictions. The differences are basically in the following:

  1. Yearly maximum. Most of the insurance has a maximum of $2500 per yearly period. Some insurances have an annual coverage for $1000, but some have no maximum on the minor treatments. The minor treatments include examination, x-ray, cleaning, dental fillings, extraction, root canal etc.
  2. Yearly deductible.  Most insurance has no deductible, but a few have $50 per family or family member.
  3. Yearly renewal date. Most of the insurance has a renewal date on the 1st of January. Some have a different date on the calendar year.
  4. Percentage of coverage. Some cover 100%, but some cover only 80%.
  5. Year of the fee guide. Most insurance pays the current Ontario Dental Association fee guide, but some pay the previous years.
  6. Supplementary coverage on major dental treatments and their percentage of coverage. Some insurance covers major dental treatments but at a reduced percentage, like 50%. The major dental treatments may include orthodontics, crowns and bridges, dentures and implants etc.
  7. Criteria for the coverage. Some only cover a limited number of examinations. X-rays and amount of dental cleaning in terms of the unit of time. Some only reimburse specific treatments with dental specialists only. For example, the insurance policy may only allow more units of time for cleaning with a periodontist only.

Because of the different coverages, working with your dental clinic to maximize your coverage each year is vital for your health and wellness.

Since it is December, for most patients, their insurance coverage periods end on the last day of this month, and it is the time of the year for those patients considering getting their needed dental work done.

The fact is that the unused benefits cannot be carried over to the new year. The other point is that if you wait until the very end of your benefit period, there may not be enough time to finish all of them, especially the more extensive treatments like crowns and bridges, endodontics with crowns etc.

Because of the many factors that can affect how much your insurance will cover for the remaining period, you will need to work with your dental clinic to figure out which treatments are more urgent and can be helped by your insurance benefits.  The rest of the required treatments can then be looked after in the new year, which is less than a month from now. In this way, your dental insurance can be fully utilized to maximize your benefits.

By getting dental treatment done before the year is over, you can also take advantage of the deductibles that you have paid for the year already.

Do not let your cavities grow more extensive, allow the gum disease to advance further or watch the infected tooth becomes swollen. You should get all the essential dental treatments done within the benefits allowance and finish the rest in the new year to have good dental health and wellness.






13 Dec, 2021

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