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Don’t leave dental benefits on the table



By Dr. Perry Francis

As we begin making holiday plans, it’s a good reminder to get dental appointments scheduled, particularly if you’ve been putting off something major. The reason? Most dental benefits renew at the beginning of the year, which means all of the money you’ve already paid toward your deductible will start over on Jan. 1, 2020.  

The National Association of Dental Plans shares that only 2.8 percent of people with PPO dental plans reach or exceed their plan’s annual maximum benefits. Many people also have Flexible Spending Accounts (FSA), which help pay for dental and medical care with pre-tax dollars, but many of these also expire at the end of the calendar year.

So how do you maximize your benefits? Start by calling today to make appointments for yourself and other members of your family, but make sure those appointments take place before Dec. 31. The earlier the better, in case you’ll need to make multiple appointments if additional treatment is necessary.

Know Your Benefits

Before scheduling appointments to maximize benefits, it’s important to understand exactly what those benefits are. Insurance plans are all different, so you’ll want to check with your agent to get the details on your specific plan, but read on for some general guidelines.

Most dental insurance plans pay for two cleanings and exams per year, and some plans require that the cleanings be six months apart. Others will pay for two cleanings in a calendar year without other stipulations. There are some insurance plans that will even pay for three or four cleanings a year.

Dr. Perry Francis

Children who see the dentist at least twice a year as recommended by the American Academy of Pediatric Dentistry have a significant advantage when it comes to long-term oral health and keeping the costs of future procedures down. Why? The more likely they are to be seen as recommended, the lesser the possibility of them needing crowns and root canals. This is because decay can be diagnosed sooner, and measures can be taken to stop the decay where it is, or to restore the tooth by filling it.

It’s important to know the frequency allowed by your dental insurance, and this is a benefit that is especially useful to take advantage of when your child is in braces — when taking care of teeth can be at its most challenging. This is a time when your dentist may advise you to bring your child in for more frequent cleanings, which lessens the possibility of decay setting in. There are also children who struggle with maintaining proper oral hygiene habits due to non-compliance or physical or cognitive limitations — these children will also benefit from more frequent cleanings.

X-rays are typically covered by your insurance company once a year. There are times when your child has a cavity that is not quite deep enough to be filled, and in these situations, a follow-up x-ray may need to be done in six months. These x-rays may not be covered by insurance but are worth the investment.

In-office fluoride treatment has been found to be effective for limiting or decreasing the chances of tooth decay. Most insurance companies cover two fluoride treatments a year, though there are others that will cover fluoride treatments only once a year.

Most dental insurance plans will offer greater coverage for preventative procedures, and they’ll almost always offer greater coverage for basic vs. major restorative procedures. So the key is to take advantage of identifying potential problems early, before you go down the path of significant dental procedures like crowns and root canals.

The Bottom Line

Our lives are filled with many activities and that becomes even more true during the holiday season. That makes it too easy to overlook or postpone dental checkups because there are no signs or symptoms of decay. Remember that by the time a sign or symptom shows up, it usually means the tooth will need more than a filling. This also means more out-of-pocket expenses. Being proactive about dental health is the best way to save money and time. 

About Wild About Smiles

Dr. Perry Francis, his wife and two children have called Reno home for 34 years. At his practice, Wild About Smiles, his team specializes in dental care for infants, children, young adults and people with special needs. He has offices in Sparks (very close to Reno, given its convenient freeway access at 395 and North McCarran) and Fallon. 

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