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The Best Ways You Can Maximize Your Dental Benefits in 2018


If you have dental benefits, you’ll want to make sure that you get the most out of them every year. However, it may be difficult to know how to make the most out of your dental coverage.

In this blog, Carmel Mountain Dental Care will give you some basic tips on how to maximize benefit coverage in 2018.




Know What Is – and Isn’t – Covered

First, you should understand what is covered and what is not covered by your dental plan. Most dental plans use a “100-85-50” model. This means that they pay for:

  • 100% of preventive/diagnostic care – This includes checkups, cleanings and oral exams.
  • 80% for basic procedures – This usually includes root canals, fillings and some other preventive treatments.
  • 50% for major procedures – Dental bridges, crowns and other major surgeries are usually placed in this category.

You should check with your dental plan provider to make sure you understand your dental coverage, as it could differ somewhat.

Hit Your Yearly Deductible (but Don’t Go Over Your Annual Maximum)

Until you reach your deductible, you’re going to pay out of pocket for most procedures. Because of this, it’s a good idea to try to hit your deductible every year so that your dental plan coverage will kick in.

However, beware of your annual maximum. This is the maximum amount that the insurance company will pay out for your dental care. A maximum of around $1,500 is the most common, though this can vary.

Get on a Spring/Fall Check-Up Routine

This is a great way to make sure that you use up your deductible. If you get a checkup each spring and fall, every payment will go towards using your deductible for that year.

However, if you have a November/May check-up routine, for example, the check-up in November won’t count towards the deductible for the next year, because coverage for dental plans rolls over on January first.

Take Care of Dental Problems Before the New Year

If you haven’t yet used up all of your dental coverage, it’s a good idea to do so before the new year. As mentioned, all of your benefits will roll over on January first. This means that, unless you use up your dental coverage before the New Year, you’ll essentially be leaving money on the table.

This is another reason that a spring/fall check-up routine is a good idea. If you have a dental problem in the fall, you’ll likely have enough time to get it taken care of before the new year, which ensures you maximize your dental benefits!

Start Maximizing Your Benefits at Carmel Mountain Dental Care!

Whether you’re in 4S Ranch, Del Sur, Carmel Valley or Rancho Bernardo, Dr. H. Jonathan Lee and Dr. Marie Ann Moeckel of Carmel Mountain Dental Care provide professional, affordable care for your entire family.

Don’t let your dental benefits go to waste. If you’re in Carmel Mountain Ranch, Rancho Peñasquitos or Poway, make an appointment at Carmel Mountain Dental Care by calling (858) 484-4880 or stopping in at 9310 Carmel Mountain Rd, Ste A, San Diego, CA 92129. Get the most out of your dental plan today.

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