2018 is almost over (we can’t believe it, either). Between work obligations, holiday gatherings with friends and family, and driving your kids around what seems like all of Berks County, it’s easy to lose track of other important things – such as whether you’ve maximized the health and dental benefits covered by your insurance.
We recognize that insurance concerns probably aren’t high on your holiday shopping list. But they should be. Each year, millions of Americans lose their yearly contributions to flexible spending accounts (FSAs). And according to the National Association of Dental Plans, 97% of Americans leave dental benefits on the table each year.
Here at Grove Dental, we want to help you assess your insurance usage and future needs to ensure that you’re maximizing your benefits and stuffing more of your own money back into your holiday stocking. Here are four areas to focus on:
Remember, an insurance deductible is the minimum amount that must be paid before the insurer pays anything. As you approach the end of 2018, consider how close you are to your deductible amounts since each will reset at the end of the plan year (typically the calendar year). If you have met your deductible already but have not reached your annual maximum, you have every incentive to take full advantage of related health care needs before the deductible resets January 1st.
While most medical insurance policies have yearly out-of-pocket maximums, most dental policies will cap your annual coverage amount. For example, if your plan maximum is $1000 and you've already reached this threshold, it may make sense to wait until January 1st for your appointment (although never delay a medically necessary treatment!).
However, if you have not yet reached your annual maximum and you expect to need minor treatment like fillings or crowns, get them taken care of before your plan resets January 1st. If you wait until the beginning of the new year you can get the same work done, but you will have used up most of your coverage for the year already. And if you need follow-up work or a second major procedure, you may be on the hook for more of those expenses.
Flexible Spending Account Balances
Flexible spending accounts (FSA) are offered by employers to many of our patients to help them offset the cost of medical expenses. Over the years, we’ve repeatedly encountered two points of confusion related to FSAs that we want to clear up:
1) FSA balances can be used for most dental procedures. IRS Publication 502 details coverages and exclusions, but the basic rule is that anything that treats or prevents a dental disease is eligible for FSA coverage. This includes teeth cleaning, fillings, extractions, and more. Typically, cosmetic procedures such as teeth whitening are excluded from coverage.
2) FSA balances do not roll over like Health Savings Account (HSA) balances. The downside of an FSA is that you must you the benefits during the contribution year. Some plans allow a 2-3 month grace period, but in general, participants lose unused money in their FSAs at the end of December. Check with your policy administrator for details and plan your upcoming medical and dental appointments accordingly.
There is one final reason you may need to use up your medical and dental benefits before the end of the year – if you have not been to the doctor or dentist at all in 2018! Whether you feel perfectly healthy or know you have a condition that requires treatment, preventative care will always save you money in the long run. Find out how much your insurance provider will pay each year and plan accordingly.
Still Have Questions?
Start investigating and asking your insurance providers the right questions to maximize your benefits in 2018 - and beyond. Find their websites, login or give them a call to find out about your deductible, yearly maximum, preventative options, and whether you have a related FSA. Here are a few dental providers that we partner with to get you started:
Take care of yourself and use all the medical and dental benefits available to you! Once you’ve figured out the insurance and financial details, schedule an appointment and let us take care of the rest!