Ten Weeks Left: Do You Know Where Your Dental Benefits Stand?
Quick question: how much of your dental insurance have you used this year? If your answer is “no idea,” you’re in good company. But there’s a catch. Many dental plans don’t roll unused benefits into the next year, so it’s worth checking what remains before your plan year ends. If yours resets on December 31, you have about ten weeks to review your coverage and plan for any recommended care.
At Summit Family & Cosmetic Dentistry, we’ve been caring for Spokane families since 2011, and we see the same story every winter. Someone has a tooth that’s bothered them for months, and they find out in January their benefits just reset. If you live or work in Spokane Valley, Mead, Nine Mile Falls, or anywhere in Spokane, our office at 220 W Francis Ave. is ready to help you use what you’ve already paid for.
Want help getting on the schedule? Call us at (509) 466-1200. Hablamos Español.
How Your Dental Plan Works (Without the Jargon)
Most dental plans have an annual maximum, which is the most your insurance company will pay toward covered dental care during a benefit year. Many plans have limits between $1,000 and $2,000, although your plan may offer more or less.
If your plan follows the calendar year, your benefits may reset on January 1. Unused benefits typically don’t roll over, although some plans offer limited rollover options. Your deductible may reset as well, depending on your policy.
Keep in mind, your annual maximum isn’t a pot of money you can spend on any procedure. Coverage depends on your plan, the treatment you need, your remaining benefits, and any applicable deductibles, waiting periods, or coverage limits.
Tips for Dental Benefits
- Many plans follow the calendar year, so they reset on December 31. Some use a different schedule, so check your paperwork or call the number on your insurance card.
- Cleanings and exams are often covered at low or no cost. Every plan is a little different, so it’s worth confirming.
- Larger treatments usually cost you less when your plan chips in.
- Some plans have waiting periods before they cover certain treatments, so ask early.
Why It’s Worth Reviewing Your Dental Benefits Before Year-End
If you have unused dental benefits, the end of the year can be a good opportunity to catch up on preventive care or discuss treatment your dentist has already recommended. Waiting to address a dental concern can sometimes allow it to worsen, although the risks depend on the underlying problem.
Rather than guessing what you need, schedule an exam if you’re due for one or have a tooth that’s bothering you. Your dentist can evaluate the issue, explain your options, and help you understand which treatments may need attention first.
Reviewing your insurance early can also help you understand your remaining benefits and plan for any out-of-pocket costs before your plan year ends.
What You Can Get Done Before the Year Ends
If you’re due for preventive care or have outstanding treatment recommendations, these are some services to discuss with your dentist before year-end:
Dental exams and teeth cleaning. The simplest way to catch problems early, and often the best-covered visit on your plan. If you’re wondering why twice a year matters, we explain it in our post on routine cleanings.- Fillings. If a tooth twinges when you eat or drink something cold, don’t wait. Not sure if it’s a cavity? Our guide on how to spot one can help.
- Same-day crowns. With a deadline coming up, it helps that a crown can be made during a single visit instead of waiting on a lab. Ask us if it’s right for your tooth. We also offer traditional bridges and crowns.
- Root canals and extractions. A tooth that keeps aching deserves attention now. If a bite hurts, our post on why a tooth hurts when you bite down walks through the possible reasons.
- Dental implants. Implant coverage varies widely and treatment often takes several visits, so if you’re considering one, start the conversation now.
Interested in something cosmetic, like teeth whitening, veneers, or clear aligners? Many plans cover little or none of it, so check with your insurance before counting on it.
Putting Off the Dentist Because You’re Nervous?
You’re not alone, and it’s one of the most common reasons people let their benefits expire. If dental visits make you anxious, tell us. We offer sedation dentistry and take the time to explain every step.
Insurance We Work With
We accept most major dental insurance plans, including Delta Dental, Regence, Premera Blue Cross, Cigna, Aetna, MetLife, United Healthcare, United Concordia, Guardian, and Humana, among others. You can see the full list and learn about payment options on our financing and insurance page.
Not sure what your plan covers? Call us, and we’ll point you in the right direction.
What About FSA and HSA Money?
If you have a Flexible Spending Account (FSA), check its deadline before the end of the year. Some employer plans allow a limited carryover or grace period, while others require you to use eligible funds within the plan year.
Health Savings Account (HSA) funds generally roll over from year to year, so you usually don’t need to spend the balance by December 31. Eligible dental expenses may qualify for payment through either account, subject to the applicable rules. Purely cosmetic procedures generally don’t qualify.
If you’re unsure about a particular expense, check with your benefits administrator or tax professional.
How to Check Your Remaining Dental Benefits
You can usually check your remaining benefits through your insurance company’s online member portal or by calling the number on your insurance card.
Before scheduling treatment, ask:
- What is my annual maximum? Find out how much your plan pays toward covered dental care each benefit year.
- How much has been used? Ask about claims already paid and any pending claims.
- When does my plan year end? Not every plan follows the calendar year.
- Which treatments are covered? Ask about coverage percentages, deductibles, waiting periods, and frequency limits.
- How much might I owe? Summit Family & Cosmetic Dentistry can help you review your treatment options and insurance information. Your insurance company makes the final coverage determination, so any estimate should be treated as an estimate rather than a guarantee of payment.
No Insurance? You Still Have Options
Navigating dental care without insurance shouldn’t mean sacrificing quality or worrying about hidden fees. A significant portion of our patients pay out of pocket, which is why we’ve built our practice around complete financial transparency and patient-first care.
To keep high-quality dental care accessible for everyone in our community, we offer flexible payment solutions designed specifically for uninsured individuals and families. Take a look at our new patient specials, or call us to talk through your options.
Have a Dental Emergency?
If you are dealing with severe tooth pain, a broken tooth, or facial swelling, please don’t wait. Dental emergencies require prompt care to relieve pain and protect your long-term health.
We prioritize urgent appointments so you can get relief as quickly as possible. Learn more on our Emergency Dentistry page, or call our team directly at (509) 466-1200 for assistance.
Ready to Make the Most of Your Benefits? Book Before the Holidays
Your dental benefits are part of what you’re already paying for, so it’s smart to use them. Look up your plan, call us, and get on the schedule before the holiday rush. A little planning now can mean a healthier smile and fewer surprise bills in the new year.
Summit Family & Cosmetic Dentistry is proud to care for patients across Spokane Valley, Mead, and Nine Mile Falls. Whether you’re due for a cleaning, ready to deal with a tooth that’s been nagging you, or just want to understand your options, we’d love to see you.
Call our Spokane dental office at (509) 466-1200 or book your visit online.