use dental insurance before it expires

Use Your Dental Insurance Benefits Before They Expire

If you have a dental insurance policy and haven’t been to our Raleigh dentist lately, then now is the time to get caught up on your to-do list. Did you know that every year you’re allowed a certain “allowance” for benefits and that if you don’t use, you lose it? Why pay into a monthly premium for a policy that is just going to waste? Let’s learn a bit more about how your insurance policy works and how you can take full advantage of its benefits before the end of the year gets here.



Understanding Your Dental Insurance Policy


Every dental plan has a benefit period, which is a timeframe of twelve months that typically runs from January 1st thru December 31st. During this time your policy will pay for a certain percentage of your treatment, up to a specific dollar amount.


The yearly maximum of your plan varies, depending on the specifics of your policy. Usually it’s an average of $1,500 but typically fluctuates between $1,000-2,000.


The exact percentage that your plan will cover depends on the type of procedure you’re getting and if there is a small deductible to apply first.  For example, after you pay a $50 deductible, a filling or crown might be covered at 50%, while an extraction or root canal might qualify for 80% coverage 一 meaning you’ll pay for half of your filling and your insurance policy will cover the other half. Or you’ll pay for 20% of your root canal treatment while your plan covers the bulk amount. Every dollar that the insurance covers come out of your yearly maximum.


Your plan provider has a benefits breakdown that you can look at to familiarize yourself with your exact policy. Also, Raleigh Dental Art’s insurance coordinators will help you understand your plan details. But the most important part to remember is that at the end of the benefit period, your unused insurance benefits do not roll, they expire. You want to use them before you “lose” them.



Take Advantage of 100% Dental Insurance Coverage on a Checkup and Cleaning


If you don’t have any teeth bothering you then you may be wondering why you should even go to the dentist to begin with. Your dental insurance policy isn’t just for getting teeth fixed, it’s about maintaining great oral health and preventing disease before it starts.


Most plans cover 100% of the following up to two times per year:


  • Regular professional teeth cleaning (prophylaxis)
  • An intraoral examination by your dentist
  • Dental x-rays


A bi-annual cleaning will help prevent cavities and keep your oral health in tip-top shape.


Dental x-rays are an invaluable tool because these images show problems that may be occurring in places that aren’t visible to the naked eye.  For example, small cavities between your teeth can be hard to detect, and abscessed teeth that aren’t exhibiting any other symptoms are usually only revealed in an x-ray.


Additionally, our Raleigh dentist’s exam is more than just checking for cavities; we look for suspicious areas in your oral cavity that might be related oral cancer, and we examine your thyroid and lymph nodes as well as your jaw joint. That’s not even including your periodontal screening!



Schedule Treatment ASAP to Prevent Emergencies and Save Money on Dental Insurance


So, what should you do if you’re told that you have a tooth that needs treatment?  If the tooth isn’t bothering you, then you may be tempted to delay care until it gets worse.  For some people this seems logical, but when it comes to your teeth, waiting isn’t usually best.


Getting teeth treated early will save you money because the cost of your treatment depends on how extensive the decay is in the tooth.  The longer you postpone treatment, the bigger your cavity will evolve to be. For example, a small cavity can be repaired with a simple filling, a medium to large cavity will need the full coverage of a more comprehensive crown.


If you choose to postpone treatment until the tooth is hurting, then that probably means that the decay has already spread into the nerve. By then, you’ll need root canal treatment to remove the damaged nerve. Plus, dental infections can allow bacteria to enter your bloodstream and contribute to heart problems.



Earlier treatment helps prevent your tooth from breaking. It also means you’re more likely not to exceed your annual dental benefits for the year. The longer you wait, the more complex your care needs tend to be. It’s best to take advantage of your dental insurance and preserve your tooth as early as possible.




Avoid Future Price Increases


Since the hit of COVID-19, everyday expenses (including dental supplies) has increased significantly. Personal protective equipment like special masks, gowns, and surgical head caps are required to be worn by clinical staff and the cost of gloves has nearly tripled. Air purifiers, plexiglass barriers, and thermometers have all been additional costs that small-business dental practices have incurred.  Not to mention liability insurance premiums going up, among other typical operational expenses. Due to the skyrocketing operational costs of running a business, some doctors are having to adjust their fees at the beginning of the year. Planning your recommended treatment done before coverage expires at the end of the year is a good way to be budget savvy.



Staying Safe During COVID-19


A lot of people are still hesitant to return to the dental office due to COVID-19. There’s no need to put off your treatment and risk worsening the condition of your tooth. At Raleigh Dental Arts we are taking every precaution to keep our patients and team members safe.



Splitting Big Treatment Between Two Years’ Worth of Dental Insurance Benefits


If you need to have a significant amount of dental treatment completed, don’t get overwhelmed and postpone your procedures if you don’t know where to start.  Our Raleigh dentist will help you prioritize your care and take full advantage of your existing dental insurance benefits.  We could even plan ahead so that you benefit from using both this year’s and next year’s full benefit amount. Here are a couple of ways how:


Dental Implants


A dental implant is a multi-step procedure that can take several months to complete.  So, if you are in need of an implant, now is the best time to get started.  We can take advantage of two years’ worth of insurance benefits by having your tooth removed and the implant placed this year 一 then after you heal for the necessary few months, we can use your next year’s insurance benefits to apply toward the cost of your implant’s new dental crown.



Root Canals and Crowns


A root canal is a treatment where our dentist removes damaged or infected nerve tissue from the inside of your tooth.  Root canaled teeth are more brittle and can break, so we typically recommend placing a strong protective crown over them after the endodontic procedure is complete.


However, a root canal is a bit of an investment. Some insurance plans will max out while covering them, leaving you responsible for the cost of the crown. Though it’s best to place the crown immediately after the root canal, we can time it separately if the year is about to end.  We would perform the first procedure this year and once next year’s insurance benefits kick in, we can use those benefits to proceed with placing the crown 一saving you an average of 50% on your treatment costs.



Crown and Buildup


In addition to a root canaled tooth, a crown is typically placed when there is a significant amount of decay or a moderately sized fracture.  Repairing these weak teeth with a filling may not be enough because it can put the tooth at risk of breaking even more. Extra coverage from a crown is recommended.


If you’re running low on insurance benefits for this year, we may be able to split your crown treatment into two sessions.  Oftentimes we can just perform the first step in preparing a tooth for a crown (which is removing the decay and building the tooth back up with a filling-like material.) At the start of next year, we can continue on with the crown preparation.


Having the buildup complete will remove all decay, preventing further spread of the decay. But you will need to be very careful with it because it will be weak until you get the final, permanent crown installed.



Limited Appointments Still Available


This time of year tends to get quite busy with people trying to use their dental insurance benefits before they expire. Fortunately, Raleigh Dental Arts still has limited appointments now through December. Give us a call right away to reserve a visit with us. We’ll give you the same undivided attention that we do all of our patients.  And if you do need treatment, our insurance coordinators will help you maximize your plan coverage before it expires. Call us today to get started!



Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.