Don’t Give Dental Insurance Companies a Year-End Bonus

Dr. Mark Grucella, DDS • Dec 12, 2018

Dental insurance is one of the most popular and valued benefits an employee or self-employed individual can have. Everyone who is covered by a dental insurance planshould take advantage of everything their dental insurance plan offers to realize its full value.

The best place to start understanding your annual dental benefits is by reading your benefits information booklet that is provided to you by your employer or dental insurance provider. Most dental insurance plans are focused on preventative care. They want to see you take care of your teeth and gums daily to avoid serious problems and expensive treatments in the future. As a result, most dental insurance plans pay 100% or nearly all the costs of routine dental check-ups, including professional cleanings and examinations. However, dental insurance plan coverages are subject to annual maximum amounts which are more fully defined and described as follows:

Three Levels of Dental Coverage

The majority of dental insurance plans offer three (3) categories or levels of coverage. Each level provides specific types of dental care treatments which may be covered by dental insurance at different percentages. The three typical categories are:

Category I – This level includes treatments and procedures that are of a preventative nature such as routine dental check-ups, cleanings, and examinations. Most dental insurance plans cover 100% or nearly all the costs associated with Category I.

Category II – This level includes treatments and procedures such as fillings, extractions, and gum treatments. Most dental insurance plans cover a slightly lower percentage of the costs for Category II compared to Category I. For example, 80% of the costs instead of 100%.

Category III – This level includes treatments and procedures that are classified as major dental care treatments and as a result, the insurance coverage is at a significantly lower percentage than Category I or Category II. For example, 50% of the costs of a treatment or procedure instead of 100% or 80%.

Enhanced Benefits

Many dental insurance plans now offer additional enhanced coverages for individuals with specific types of health conditions where additional dental care has proved to be helpful. For example, individuals with diabetes, or heart conditions.

Benefit Period of Dental Insurance Plans

Dental benefits are typically calculated within what is known as a “benefit period” and most benefit periods have a duration of one year before they expire and are re-calculated for the next year. While most follow a calendar year, not all do. Some are on a fiscal year basis. Therefore, it’s important to know exactly the start and end dates for your benefit period and where you are at in that time frame so that you can take full advantage of the coverage offered during the benefit period.

Annual Maximum Amounts of Coverage

It’s common for dental insurance plans to have what’s known as “annual maximums”. This is the maximum dollar amount a dental insurance plan will pay for dental care within a benefit period.

While the annual maximum amount varies between different dental insurance providers, the average tends to be in the ballpark of $1,000 per year, per person. The annual maximum usually renews on January 1st (if your benefit period is on a calendar year basis). Any unused amounts will not roll-over from one year to another. Therefore, it’s best to use them before the yearly benefit period runs out. Otherwise, you will most likely lose them.

Need Help Determining Remaining Dental Insurance Benefits for This Year?

Like most types of health insurance, dental insurance can get complicated and confusing. If you have questions or need assistance with understanding what annual dental benefits you may have left this year, please contact us by calling 330-733-7911 or send us your dental insurance information by visiting our website and submitting your dental insurance information to us privately and securely. Here’s the direct link to our website dental insurance page: https://www.akronbestdentist.com/dental-insurance-information

Hurry! December 31st will be here soon. The year is quickly coming to an end and so are your annual dental benefits. You don’t want to miss out on any benefits you have earned and are entitled to receive with the monthly premiums you and/or your employer have paid to the dental insurance provider throughout the year. Otherwise, you’ll just be giving the dental insurance company a year-end bonus.

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Just Like Halloween, There’s Really Nothing To Fear

By Dr. Mark Grucella • 22 Oct, 2022

Halloween can understandably be a scary time of year. Afterall, when October rolls around, we start seeing the emergence of witches, ghosts, ghouls, goblins, vampires, bats, spiders, and everything else that can make the hair on the backs of our necks stand up. But then, October 31 st comes and goes, and we realize, there really wasn’t anything to fear in the first place. It was just our worries, anxieties, or the unknown running wild and getting the better of us. Time and time again, our new patients tell us how dental care can be a lot like Halloween. They have anxiety because of the unknown, or they had an unfavorable experience in the past that resulted in a reluctance to continue to seek care on a regular basis. We are proud to say we were a breath of fresh air for these patients. Once they came to us, they discovered there really wasn’t anything to fear and now look forward to each and every appointment so they can enjoy the many benefits of routine dental care. As we like to say, “Our Dental Care Does Not Scare” and here’s why: Friendly, Fun, Non-Judgmental Style of Care When patients come to one of our three Akron-Canton area dentist offices, they find a welcoming and friendly team of professionals focused only on the comfort, care, and well-being of our patients. We also like to have some fun! In addition to being dedicated dental professionals, we are sports fans who like to support our teams. When there’s a big game, you’ll see each of us wearing our favorite team’s jersey whether it’s the Guardians, Browns, and yes, even the Steelers. Holidays also provide us with great opportunities throughout the year to incorporate some fun by decorating our offices and ourselves with the applicable ornamentation. What’s really special is watching how our patients love to join in on the fun and dress up for the big games and holidays too! Informing and Empowering Our Patients Before we proceed with any type of care, we provide our patients with all the information, explanations, and answers to questions they want. Costs are also shared up-front so approval can be given and there are no surprises. We make sure our patients are always in charge of their individual care. Navigating Dental Insurance Benefits Like any type of insurance, dental benefits can get complicated. What’s covered? What’s not? Am I taking full advantage of all my dental insurance benefits? These are just a few of the most frequently asked questions by our patients. We help you navigate your dental insurance plan and understand all your benefits. No Dental Insurance, No Problem Not everyone has a dental insurance plan and the ability to minimize their out-of-pocket dental care cost. That’s why we created an in-house discount dental plan. It helps our patients who are not covered by dental insurance save on everything from cleanings and fillings to cosmetic procedures and crowns. See Why There’s Nothing To Fear While many people put off dental care because of worries or anxieties, we invite you to give us a try by scheduling an appointment at one of our three Akron-Canton area dental office locations. Please call us at 330-733-7911 or send us a request for an appointment here on our website by visiting this link: REQUEST APPOINTMENT Just like Halloween, we’re confident you are going to see there really is nothing to fear. In fact, you may just find you’ll have some fun!