Maximizing Your Dental Insurance Annual Maximum

What Is A Dental Insurance Annual Maximum?

For your employees with a dental PPO plan, usually there is a finite “Calendar Year Maximum” (CYM), i.e. the maximum dollar amount a dental insurance carrier will reimburse dental providers for services that members receive over a calendar year. This is important to note in the fall as it is not uncommon that people have used little to none of their CYM by that point. Because the CYM resets at the beginning of every calendar year, CYM dollars are “use it or lose it” (unless you have a dental plan with a “Max Rollover”. Contact us here if you have questions about this nifty plan feature).

How Can Employees Take Full Advantage of their Annual Maximums?

This fall, if your employees find themselves in a position where they need any significant dental work done (fillings, periodontics or endodontics, crowns, implants, etc.) and they have dollars remaining on their CYM, it is in their best interest to get some or all of the work done before the plan’s CYM resets at the end of the year. If your employees are unsure of what their needed dental work will cost them and how to plan appropriately, they may benefit from a pre-treatment estimate if they are:

• Planning dental work that will likely exceed $300, like a crown, wisdom tooth extraction, bridge, dentures or periodontal surgery
• Wondering if a procedure is covered by your plan
• Worried a procedure might exceed the annual plan maximum
• On a budget and need to plan their payment in advance

AEIS: Helping You Navigate Your Health Insurance

With a little planning and some timely advice from your benefits broker/advisor your employees can ensure that they make the most of their dental plan which in turn raises their value perception of the benefits package that you provide them. For more tips and strategies on how your employees can get the most out of your benefits offerings, schedule a call with us and talk with the experts!