Navigating Your 2026 Dental Benefits

2026 is right around the corner and now is the time to familiarize yourself with any changes to your dental insurance benefits to prepare for next year. Take time to read and understand your insurance benefits. Insurance plans can be sneaky and word things in ways that lead the patient to believe their coverage is better than it truly is. We have team members who specialize in helping patients understand their insurance plans so they can maximize their plan for their specific needs.

To ensure you receive the full value of your plan, it's important to stay on track with the recommended care. At Elite Smiles Dental, we suggest visiting every 6 months for your routine cleaning and exam. This will help us to find issues early and fix them when they are minor and less expensive. Remember, dental issues never get better with time; they only get worse.

Planning ahead is also key. Taking care of necessary treatment early in the year allows you to better plan for the rest of the year, or even next year. It also gives you the opportunity to save patient portions on future treatment. We like to give patients treatment plans that have phases when there is more than one appointment needed. We phase the treatment to address the most urgent items first, and the less important or slower progressing issues later. This allows the patient to take the treatment as they can afford without sacrificing the urgency of some issues. This also allows us to show the patient how their dental insurance will help, and to plan for their out-of-pocket costs.

For any costs, we always provide our patients with a step-by-step breakdown of total cost of treatment, what we expect the insurance to help with, and what their portion will be. We also discuss the different options for payment such as cash, check, credit card, or Care Credit if they need to spread their payments out.

Keep in mind that you will likely have out-of-pocket expenses. We’ve noticed insurance companies have gotten sneaky in how they word their policies. Their goal is to cover as little as possible. So, they might tell you that you get two cleanings and exams per year, but they often require that this stays within your yearly maximum as well. An example would be if you get $1,000 coverage per year and you use the full $1,000 toward fillings in January, the insurance will NOT cover anything further in most policies. We will always try to help that patient maximize how their insurance will help them pay for this treatment.

And if you’re not sure what you may need, don’t worry! We always send reminders when patients have outstanding treatment, regardless of insurance status. We do not allow insurance to dictate what we diagnose, as we have the patient's best interest in the forefront.

Make it a goal in 2026 to get the care you need! See your dentist, have them give you an idea of what is on the horizon for the year, and make a plan on how you will tackle this plan using your benefits.

We hope you have a wonderful start to the year and we’ll see you in 2026!