It’s time to review your annual dental benefits before they are lost. Most employer-sponsored health insurance plans are on a calendar year. This means that the current year plan expires the last day of each year, renews in January and any unused benefits for the current year will be lost. If you have dental benefits coverage in your employer-sponsored health insurance plan you may have unused dental benefits available to you and your family. If you have unfinished dental treatment, including cosmetic treatment, you may want to consider using these benefits. You may be able to phase bigger treatment plans over two years of coverage doing some treatment at the end of this year and some at the beginning of next year. This way you get two years of benefits in a short period thus maximizing your benefits, minimizing your out of pocket expenses and optimizing your dental health.
Traditional health insurance plans often include dental benefits. The medical side is designed as insurance, it covers the possible catastrophically high expenses of some medical illnesses. The dental side is not insurance, it is a defined benefit. Employers and insurance companies define how much money will be available and what treatment areas are covered. Over the last 30 years, the cost of health insurance has skyrocketed so to keep their costs down employers have increased deductibles, out of pocket maximums and decreased the level of dental benefits. Several years ago it was common to have $2500 of dental benefits and now $1000 is more common. The decreased benefit and increase in the cost of living have left patients with more out of pocket expenses.
If your employer is interested in saving money in the area of employee benefits they may want to consider two alternatives to offering dental benefits tied to the health insurance plan. These alternatives are health savings accounts and cafeteria plans. Employers usually have an option to offer different types of coverage for their employees. The health savings account option raises the deductibles and out of pocket maximum but allows you and your employer to contribute to a health savings account. This account is owned by the employee and can be used for medical and dental expenses. The money is not lost at the end of the year, it carries over and is usually held in an interest-bearing or investment type account owned by the employee that can grow over the years. For healthy young people, this is a great way to save for cosmetic procedures or for the expenses that may be incurred later in life when health and dental expenses usually go up. Cafeteria plans are another way employers can offer less expensive benefits to employees. Cafeteria plans are funded by the employer for each employee on an annual basis and they are usually using it or lose it annually. If these funds are not used, they go back to the employer. Both health savings accounts and cafeteria plans give the employee much more latitude on how to use these funds, they are not limited by what the insurance company defines as a covered benefit, so things like cosmetic care are covered.
Look at your current health care or cafeteria plan to determine if you have unused dental benefits that expire in December. If you have unfinished dental treatment or cosmetic treatment you need or want, now is the time to use these benefits. If you do not have a health savings account or cafeteria plan, now is the time to discuss with your human resources representative or your employer the possibility of adding a health savings account or cafeteria plan option for next year.
Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, visiting faculty at Spear Education, an alumnus of Pankey Institute, a member of the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association. Dr. Gallegos practices dentistry in Middleburg, VA. www.MiddleburgSmiles.com.