Do you ever wonder why dental insurance has a yearly maximum? Occasionally, when we present treatment copays to patients they are unaware that their insurance has a max on how much they pay in a benefit year. They feel that the maximum is pretty low especially compared to medical insurance. The average dental insurance yearly maximum is $1000 - $2000 where medical insurance maximums are in the millions!
We’ve asked insurance companies why yearly maximums are typically around $1000 and have remained this way for decades even though the cost of procedures and insurance premiums has gone up considerably. One of their answers is that most insurance holders don’t even use the $1000, so there doesn’t seem to be a need to increase it. This is an unfortunate statistic for our patients with major restorations who go beyond their yearly insurance maximum.
We are here to help you get the most out of your dental insurance and below are 5 tips on what you can do to play a part in saving money by getting the most out of your dental insurance benefits.
5 tips to get the most out of your dental insurance yearly maximum:
1. Know your yearly maximum.
The first step in getting the most out of your insurance each year is to understand your plan and know your yearly maximum. Many patients don’t know what they’re working with, so they hold off on treatment. Our financial coordinators try to inform patients that they are leaving benefits on the table when they need treatment, but with thousands of patients to track, it’s very hard to catch this every time it happens.
2. Ask for help.
Insurance is sometimes tricky to navigate. Our front desk and financial coordinators know insurance inside and out and are here to help you. If you have a treatment plan and you see that your insurance is maxing ask them the best way to utilize your insurance with your treatment needs.
3. Sometimes it’s best to schedule your treatment in one plan year.
In some cases patients have minimal restorative work and their treatment plan fits within their yearly maximum. This is a great example of when you’d want to get your treatment done within one plan year to only have to pay one deductible. Our team can help you plan this way to save you about $50-$100 out of pocket.
4. Take advantage of your plan renewal time.
It’s always good to know in addition to your plan maximum when your plan renews. Most plans renew on January 1st; however, some plans renew at other times of the year depending on how they are set up. If you are planning restorative work that requires multiple steps like an implant or crown and you know your plan renewal is approaching, you could save thousands of dollars by timing your appointments correctly. The implant process is a great example, because if you have a $1500 yearly maximum and you place the implant in one year and 3-4 months later place the abutment and crown in the next plan year, you get to use $1500 from your insurance twice!
5. Make sure your insurance plan fits your needs.
Sometimes patients have plans that just don’t fit their insurance needs. There are many plans and individual treatment needs and they don’t always line up. If you have access to employer offered insurance especially if the premium is subsidized by your employer that is typically the best option. If you’ve selected a plan through a different avenue and find that your co-pays seem very high, talk to our front office team, because we can evaluate what you have and help make suggestions. At Madison No Fear Dentistry, we have a dental subscription plan for our patients with no or little insurance coverage. This works great for patients having trouble with their insurance maximum limitations, because there are no yearly maximums with our Wellness Program. All treatment is discounted, even elective sedation and cosmetic procedures,which makes it a great alternative to traditional dental insurance for many patients.