Many dental plans start over at the end of the year, and unused benefits often don’t carry over. Here’s how annual maximums, deductibles and FSAs usually work, what to schedule, and how to check your own plan.
Do dental benefits reset at the end of the year?
For many plans, yes. Most dental plans run on a calendar year or a plan year set by the group, and a new annual maximum and deductible apply when coverage renews. For most plans, unused benefits don’t roll over. Check your plan documents for your date, or call (951) 677-1054 and our team is happy to help.
When does my dental plan year end?
For many people, it ends on December 31. MouthHealthy, the American Dental Association’s patient site, notes that many insurance companies have a benefit deadline of December 31.
Not every plan works that way. Most dental plans run on a calendar year or a plan year that can vary by group, MouthHealthy explains, and HealthCare.gov notes that a plan year may not match the calendar year.
Your plan documents or benefits office can tell you your date. That’s why Dr. Neff’s letter to patients included this reminder: “Many dental benefits renew at the end of the year, and our team is happy to help you use yours before then.”
Do unused dental benefits roll over?
Usually not. MouthHealthy says unused benefits don’t roll over into the new year for most dental plans.
Many people leave benefits behind. MouthHealthy, citing the National Association of Dental Plans, reports that only 2.8% of people with PPO dental plans reached or exceeded their plan’s annual maximum.
At a glance
Your year-end benefits checklist
Five quick steps before your benefits reset.
- Find your date. Check when your plan year ends. Many end December 31, but not all.
- Check what’s left. Ask how much of your annual maximum remains and whether you’ve met your deductible.
- Check your FSA. Find your deadline and whether you have a grace period or carryover.
- Book your checkup early. Most plans typically pay 100% for preventive visits.
- Finish what you started. Ask about treatment you’ve put off or haven’t completed.
How do annual maximums and deductibles work?
Here’s what the two key terms mean, based on MouthHealthy’s definitions:
- Annual maximum: the total dollar amount your plan will pay during the plan year. Family plans may have separate limits for each person and for the family.
- Deductible: the amount you pay out of pocket before your plan begins covering costs. A new deductible applies when your coverage renews.
- Other rules: a plan might cover no more than two cleanings per calendar year, and some plans cover cleanings and diagnostic services with no deductible.
Why timing can matter
If you’ve already met this year’s deductible, care you get before your plan renews may cost you less than the same care after a new deductible starts.
Can I use my FSA or HSA for dental care?
Usually, yes. HealthCare.gov says a flexible spending account (FSA) can pay for certain medical and dental expenses for you, your spouse and your dependents.
FSA money has a deadline. You generally must use it within the plan year. Your employer may give you up to 2½ extra months to use it or let you carry over a limited amount, but not both, and money left after that is lost.
A health savings account (HSA) is different. It’s a pre-tax account that goes with an HSA-eligible health plan, and the IRS says money left at the end of the year generally carries over.
The IRS counts dental care such as cleanings, sealants, fluoride treatments, X-rays, fillings, braces, extractions and dentures as medical expenses. Ask your plan administrator what your account covers.
What should I schedule before my benefits reset?
Start with a checkup and cleaning if you haven’t had one this plan year. MouthHealthy notes that most plans typically pay 100% for preventive visits. See what happens during our cleanings and exams.
Next, think about treatment you’ve put off or started but haven’t finished. Dr. Neff’s letter invites anyone in that spot to come in and meet Dr. Pourshirazi.
Waiting can let problems grow. The National Institute of Dental and Craniofacial Research says untreated tooth decay can cause pain, infection and even tooth loss.
Don’t wait if something hurts
A toothache, swelling or broken tooth shouldn’t wait for a benefits date. Call us at (951) 677-1054 or read about emergency dental care. Call 911 or go to the nearest emergency room for facial swelling that affects your breathing, swallowing or vision, a high fever with swelling, bleeding that won’t stop, or a serious injury to your face or jaw.
How do I check how much of my dental benefit is left?
Call the number on your member card, or call our Murrieta office at (951) 677-1054 and our team is happy to help. Have your plan name, member ID and group number ready.
Questions to ask your plan
When does my plan year end? How much of my annual maximum is left? Have I met my deductible? How is the treatment I need covered?
Do you still accept the UFCW dental plan?
Yes. We continue to accept the same insurance plans as before, including the UFCW member dental plan, and Golden Triangle Dentistry is on UFCW Local 1167’s list of contracted dental providers.
Local 1167 says members “should always verify coverage with the provider before treatment begins,” and members in prepaid dental plans aren’t covered through the listed providers. See our UFCW dental plan page and dental insurance page.
What if I don’t have dental benefits?
You’re still welcome at our Murrieta office. We accept cash, check, Visa, MasterCard, Discover, American Express and CareCredit, and more payment choices with flexible financing options are being added. See payment options and financing, or request an appointment today.
Questions & answers
Common questions
Is it too late to schedule a visit before the end of the year?
It’s worth calling. Call (951) 677-1054 and our team will tell you what’s open. If your plan year ends on a date other than December 31, you may have more time than you think, so check your plan documents too.
What if my plan year doesn’t end in December?
Then your deadline is the end of your own plan year. MouthHealthy suggests checking your plan document or asking your employer. Your annual maximum and deductible follow that same schedule, so the same tips apply, just on a different date.
Can I use my FSA or HSA for teeth whitening?
Usually not. IRS Publication 502 says amounts paid to whiten teeth can’t be included as a medical expense, and it generally excludes cosmetic procedures. Your account’s rules decide what it pays for, so check with your administrator. Learn more on our teeth whitening page.
Can I split larger treatment across two plan years?
Sometimes. Because a new annual maximum and deductible apply when coverage renews, some people plan larger treatment across two plan years. Whether that makes sense depends on your needs, so talk with your dentist and your plan first. Don’t put off care that shouldn’t wait.
Will my benefits work the same now that Dr. Pourshirazi is here?
Yes. Dr. Neff’s letter says we continue to accept the same insurance plans, including the UFCW member dental plan, and your records stay right here. Your coverage still depends on your own plan, so confirm your benefits before treatment begins.
Keep reading
Related care and answers
Dental Insurance & UFCW Plans
We still accept the same insurance plans, including the UFCW member dental plan, and work with most PPOs. Lear
UFCW Dental Plan Dentist in Murrieta
Golden Triangle Dentistry is on UFCW Local 1167’s contracted dental provider list and still accepts the UFCW m
Payment Options & Financing
Pay by cash, check, Visa, MasterCard, Discover, American Express or CareCredit, with more financing choices on
Dental Cleanings & Exams
What happens at a dental checkup: cleaning, exam, X-rays when needed, oral cancer screening and gum checks. Us
Book a Visit
Call (951) 677-1054 to book a visit at Golden Triangle Dentistry, 25460 Medical Center Dr, Suite 202, Murrieta
Sources
- Use Dental Insurance Before the End of the Year · American Dental Association (MouthHealthy)
- Choosing the Right Dental Plan for You · American Dental Association (MouthHealthy)
- Dental Plan Benefits & Limitations · American Dental Association
- Plan year (glossary) · HealthCare.gov (U.S. Centers for Medicare & Medicaid Services)
- Using a Flexible Spending Account (FSA) · HealthCare.gov (U.S. Centers for Medicare & Medicaid Services)
- Health Savings Account (HSA) (glossary) · HealthCare.gov (U.S. Centers for Medicare & Medicaid Services)
- Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans · Internal Revenue Service
- Publication 502, Medical and Dental Expenses · Internal Revenue Service
- Tooth Decay · National Institute of Dental and Craniofacial Research
- Provider List · UFCW Local 1167
- Tooth Abscess: Symptoms, Causes & Treatment · Cleveland Clinic
- What Is a Dental Emergency and Where To Go for Care · Cleveland Clinic
- Ludwig angina · MedlinePlus (U.S. National Library of Medicine)
- Orbital cellulitis · MedlinePlus (U.S. National Library of Medicine)
Golden Triangle Dentistry is not affiliated with these organizations. Links open in a new tab.
Important information: This article explains how dental benefits, FSAs and HSAs generally work and isn’t tax or insurance advice. Your own plan decides your coverage, so confirm your benefits before treatment begins.