Take Advantage of Your Dental Insurance Before Year End - Without Letting It Take Advantage of You
As Thanksgiving approaches, the to-do list increases with tasks and activities ramp up. Take a moment NOW to evaluate the status of your dental insurance, that is, if you’re fortunate to have such insurance.
Almost all dental insurance plans are tied to a calendar year schedule, as opposed to a fiscal year schedule or one based on your anniversary hire date. They usually have annual maximums that disappear if the monies are not used. For example, your annual maximum may be $2,000 and, thus far, you’ve only used $500. The remaining $1,500 of dental benefits are available for dental services through December 31. If it isn’t used, then that amount will go away and a new annual maximum will begin on January 1, 2023.
Provided you have dental work that needs to be done, be proactive and schedule the work for this calendar year. Why let the $1,500 go unused? Or if you’re due for a cleaning and examination, schedule it now. (Sometimes preventive services such as cleanings are exempt from the maximum, but this is determined by your individual plan.)
Schedule Early
Contact your dentist today and schedule your appointment. I recall so many times when a patient would call on December 29, urgency in his voice, and say, “I need a crown done before the end of the year. Can you get me in?” The schedule would inevitably be completely full by then.
Adding to the difficulty in securing an appointment, some dental offices close between Christmas and New Year’s. That’s also the time when students are off or home for holiday breaks, so it becomes even more important to plan ahead.
When told that there is no availability, often the next question is, “Well, can we do the crown next year but bill it in this calendar year?” This type of question, while understandable, (no one likes insurance companies…) puts your dentist in the awkward position of partnering with you in insurance fraud. It puts her professional license at risk and has even meant jail time for egregious and repeated transgressions.
What if your dentist’s office calls you?
Conversely, some dentists are also guilty of putting their patients in uncomfortable situations. You may receive communication from your dentist, saying something like, “Don’t let your unused dental benefit lapse. Let’s replace those old silver fillings with new, more esthetic white ones before yearend.”
For starters, those silver fillings may be fine. Mine have lasted for decades. It seems obvious to say that just because something is old, it doesn’t necessarily mean the filling needs replacement. Secondly, with most procedures other than preventive ones, there is usually some copayment involved. Ask about the out-of-pocket costs before you proceed.
Health FSAs
To complicate matters, you may have a health FSA through your employer. An FSA is a flexible spending account where you can allocate pre-tax dollars to be spent for, in this case, your health needs including your dental care. The amounts are regulated by the Internal Revenue Service. In 2022, the maximum FSA contribution limit is $2,850 and this increases to $3,050 for 2023.
The IRS also regulates the unused amount that may be carried over to the following year. In 2022 it is $570 and will increase to $610 in 2023. Be aware that any unused FSA contribution beyond the carryover amount will likely be forfeited entirely. In other words, you will lose that money as income. The window for deciding your individual contribution limit for the following year varies by employer. One thing is certain: Without concrete data, you need to make an educated guess as to how much to allocate toward your health FSA for the next year. And then, except for the allowed deferred amount, you need to use it all up.
Planning is key
Most people are unable to complete extensive dental treatment in one uninterrupted series of appointments. Either due to scheduling or financial restrictions, treatment may need to be broken up and sequenced. If you have extensive dental needs, it’s essential to establish a treatment plan with your dentist which prioritizes the treatment and takes into account financial aspects such as insurance and FSA contributions. By doing so, you’ll be able to take full advantage of financial assistance toward your dental needs.
