The autumn leaves are falling … don’t lose your 2015 dental insurance benefits


As we get into the beautiful autumn months, our patients are now planning their dental treatment with their remaining dental insurance benefits for 2015. Whether your dental insurance plan is with Aetna Dental, Guardian Dental, and Humana Dental, or one of the many other PPO plans we take, you will want to make sure you get into to see us this year to maximize your potential benefits. Your dental insurance plan may have a maximum benefit of $1000, $1500 or even more. But for the calendar year plans, you will lose that benefit amount entirely if you don’t use it before the end of the year. All dental insurance plans, including those provided through Aetna Dental, Guardian Dental, and Humana Dental, can be a little different, so if you are unsure of any of your plan information, please give us a call and if we don’t already have the details; we can certainly try to find them out for you.

We have some of our patients who have already used some of their benefits and some that haven’t been in at all. But if you have dental concerns or questions, or just need to have your teeth cleaned, now is the time to contact us to arrange your dental appointment. As fall arrives, more and more patients are scheduling, so the appointment times become more limited. Also, we have found that certain dental plans provided by Aetna Dental, Guardian Dental, and Humana Dental, may only pay on the completion date of certain services. For instance, if you begin a crown in 2015, you must have that crown seated, or cemented in 2015 as well. Or the benefits will be paid from your 2016 plan, provided your company still has coverage with that plan.

Some dental insurance plans, such as Aetna Dental, Guardian Dental, and Humana Dental even have roll over benefits to use if you earn them. So you could have even more available benefits than your set maximum. Unfortunately, sometimes waiting to do all your dental needs until each year rolls around so your insurance company can help cover the costs, can result in additional needs. For example, the small filling that you were waiting to do can increase in size and become an onlay or crown, which in turn can increase discomfort, and the cost can increase as well.

There are so many dental insurance plans out there, including Aetna Dental, Guardian Dental, and Humana Dental, that can be available to you through your employer or as an individual dental insurance policy. The full coverage dental plans have declined in recent years, but many times your copayment amounts can be less than you think. Please let us help you find out what your coverage includes. We always try to let you know what your copayments are in advance, so that planning your dental treatment is as smooth as possible.  

Now that the leaves are changing colors, it is also time to think about your dental needs for 2016. Many employers have enrollments now for next year so that you can decide what benefits you may need and want to take advantage of. If you have a lot of dental work to be done, now could be the time to elect to change your dental benefits with Aetna Dental, Guardian Dental, and Humana Dental, or if you do not have dental insurance, you may be able to enroll for the first time with your company. Many times, a small increase in your monthly premiums to your employer can give you a lot more dental benefits with Aetna Dental, Guardian Dental, and Humana Dental to use, or increase your coverage for certain services to fit your needs.

This is also the time to sign up for your flexible spending account or health savings account, or even increase your total if possible. Insurance companies, such as Aetna Dental, Guardian Dental, and Humana Dental, will even coordinate with those plans. We have found that cosmetic dentistry, including, but not limited to Invisalign and porcelain veneers or crowns, is also covered many times by your health savings or flexible spending plans. If this is something you have thought about in the past and would like more information, we would be glad to answer any questions we can.

If you have remaining money in your flexible spending account, you will need to use those also within the current year. This means that the treatment has to be performed in 2015, not just paid for in the same year.

Our office has worked with Aetna Dental, Guardian Dental, and Humana Dental for many years and has coordinated their benefits with our patient’s needs. We have different payment options that are available to you, including a 12-month interest free plan if you are interested. Please let us know if we can help you achieve your dental needs for the remainder of 2015 and into 2016. If your only concern is having your teeth cleaned and you have not been in twice this year, we would certainly want to get an appointment scheduled as well. Most of the major dental insurance plans, including Aetna Dental, Guardian Dental, and Humana Dental, pay either twice a year or once every six months, so please call to find a time that works well for you. Once again, if you are unsure about any of your dental insurance benefits, please allow us to help any way we can. Dental insurance is continuously changing, and we want to see all our patients get the most out of their plans!