Dental Insurance... Use it or lose it?

Dentistry can be expensive, especially when the dentist has to handle problems on an emergency basis. Many patients wait until something hurts them and often their pain is due to an infection that will necessitate a root canal or an extraction. Either way this scenario can easily become expensive since most teeth will need a post and/or core and a crown afterwards or in the case of an extraction, they will need an implant replacement or a fixed bridge which are even more costly.

While many of our patients have dental insurance that covers a high percentage of their dental work, especially for treatment plans that are less than $3000,  most plans run on a yearly basis, ending on December 31. Any insurance benefits  that are unused by the end of the year are lost forever. 

Since our patients often have long term, staged treatment plans that allow them to do some of their planned work each year, so that they can maximizes the amount their dental insurance will contribute. Often these patients have "large interim fillings" that will function like "dental duct tape" to keep their teeth from becoming decayed, until they are ready to restore the tooth with a crown. These interim fillings are less expensive than permanent fillings and inhibit decay formation, but they do not lessen the risk of a tooth fracture. These interim fillings only replace missing tooth structure, but do not protect remaining tooth structure from occlusal forces the way that full coverage (crowns and onlays)would. It is clearly better for our patients not to delay restoring these teeth and certainly not to wait until these teeth start hurting!

Many of  our patients who need crowns often prefer to have a pre-certification sent to the dental insurers. For them and others who haven't been this year, it is probably time to see their dentist in order to allow time for their insurer to process any desired pre-certifications , which can take 4 weeks or more. If a patient has unused insurance benefits, clearly seeing their dentist now is a good idea, especially if they are due for a re-care appointment, since this will allow time this year to have any needed dental work to be submitted for the current calendar year.