Reviewed by Dr. Avy Ariyev, DDS · Smile Studio of Great Neck
Short answer: many dental plans reset on January 1, and whatever you don’t use usually doesn’t carry over. If you’ve already met your deductible or still have part of your annual maximum left, booking cleanings, fillings or crowns before December 31 lets your plan pay its share before the year runs out.
Why do dental benefits run out?
Most PPO plans have an annual maximum, which is the most the plan will pay in a year. Whatever is left on December 31 is usually gone, and your deductible starts over too. It’s one of those things almost everyone forgets until mid-December, when the schedule is already full. You can see the plans we work with on our insurance and financing page.
What’s worth booking before the year ends?
Start with your second cleaning and exam if you haven’t had one this year, since many plans cover those at a high percentage. Next, anything your dentist already recommended, like a filling or a crown you’ve been putting off. Replacing a broken or worn filling is another good one. And if you need more than one treatment, it may make sense to start now and finish in January.
Can treatment be split between two plan years?
Sometimes, yes. If you need several things done, we may be able to do part in December and part in January so both years’ benefits help.
How do you find out what’s left?
Log in to your insurance company’s website or call the number on the back of your card. Look for your remaining annual maximum and whether your deductible has been met. If that sounds like a chore, just call our front desk at 516-487-3655 and we’ll check for you.
What about FSA and HSA money?
Many flexible spending accounts (FSAs) also have a year-end deadline, so it’s worth checking your balance. Health savings accounts (HSAs) usually roll over. Either way, eligible dental care is a good use of those funds.
What if you don’t have dental insurance?
Our in-house membership plan covers routine preventive care for a yearly fee and gives you savings on other treatment. There are no deductibles, waiting periods or claim forms to deal with.
Does insurance cover cosmetic work?
Usually not. Treatment done only for appearance, like whitening or veneers, isn’t normally covered. For reference, Opalescence™ whitening is $350 for new patients (regularly $450), veneers are $1,795 to $2,200 per tooth, and Invisalign® is about $5,300. The membership plan may offer savings on these, and you’ll always get a written estimate first.
Why bother with preventive visits?
Using up benefits is a nice bonus, but the real value of a cleaning and exam is catching small problems early. A cracked filling or a spot of early decay found in December is usually quicker and less expensive to fix than a crown you need six months later.
A quick year-end checklist
Check your remaining maximum and deductible. Look up your FSA balance and its deadline. Book your cleaning if you’re due. Ask about anything that was recommended earlier in the year. And book early, because late December is usually our busiest stretch. We’re a short walk from the Great Neck LIRR station, so a lunchtime or evening visit is easy to fit in.
Frequently asked questions
Does every plan reset on January 1?
Many do, but some run on a different plan year. Check your plan documents or ask us and we’ll look it up.
What happens to benefits I don’t use?
In most plans, the unused annual maximum is lost and the deductible resets.
Do you take my insurance?
We work with many PPO plans. Call us with your plan details and we’ll confirm.
December fills up quickly. Call 516-487-3655 or book online at Smile Studio of Great Neck.
Individual results vary. Prices are estimates; your exact cost is confirmed in writing at your consultation. This article is general information and isn’t a substitute for an exam.