Like many Canadians, you may have a dental plan through your employer, union or provincial government. A dental plan is a benefit that can help you pay for your dental treatment. There are some easy strategies to make sure you’re getting the most of your benefits.
- The most important way to get the most out of your plan is to make sure you know how your plan works. Read the booklet or other materials available from your provider. Because of privacy rules, dental plans will not share some information about your particular plan with your dentist. Knowing your plan helps both you and your dentist optimize your dental budget. Some useful things to know about your plan include dollar limits on coverage, ability to choose a procedure other than the one your plan covers, coverage changes in the event of a job change and coverage for basic dentistry (like fillings and root canals) versus major dentistry (like crowns and bridges).
- The majority of dental plans have a financial limit that renews annually, usually on January 1st of each year. As the end of the year approaches, consider maximizing your benefits by completing (or at least starting) any outstanding treatment before your plan’s anniversary date. Come next year, you’ll have a full year of benefits again.
- You may be eligible for cleanings more frequently than you think. Most plans allow polish, fluoride and an exam every 6, 9 or 12 months. However most plans have more room for tartar removal which is the hygiene treatment that really keeps your gums healthy. Check how many units of tartar removal you have allowable, this is usually called scaling or root planing. The average dental plan allows from 4 to 16 units, which could mean cleanings up to four times per year.
- Know with which procedures you can get sedation covered. Often, if plans don’t cover sedation generally, they may cover sedation in conjunction with oral surgery such as wisdom tooth removals and tooth extractions.
- Many plans will not guarantee coverage for various procedures, even if it is an included benefit. You can ask your dentist to submit a preauthorization to your dental plan administrator for a predetermination of benefits. This is not a guarantee but it does reduce the chances of your claim for reimbursement being limited or declined. Remember that your dentist is treating you, not your dental plan.
- Use the online tools and resources offered by your plan. Easy-to-use online resources for desktop and mobile devices make it faster to get information about your plan. You can also access a summary of the services you’ve received, track your benefit usage and how much is remaining, and even sign up for faster reimbursement through direct deposit.
- Know the difference between a dental plan and a treatment plan. A treatment plan is the personal plan you and your dentist develop together to meet your oral health needs. It serves as your roadmap to good oral health and should not be limited by what a dental plan will cover.
If you have questions about how we can help you get the most out of your dental plan, please contact us.