Making the following three open enrollment choices can make your dental implant treatment more affordable.
Open enrollment is the one time each year you can change your health benefits to best serve your healthcare needs for the coming year. If you intend to receive dental implant treatment in 2023, the choices you make can help you save a few hundred dollars or maybe even a few thousand dollars.
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- Choosing Your Dental Insurance Plan
- Opting into a flexible spending account
- Considering funding a health savings account
- Open enrollment choices can make a difference in dental implant affordability
1. Choosing your dental insurance plan
When it comes to dental insurance options, making the best choice for dental implant coverage can be the difference between having some dental implant coverage or none at all. Most would agree some insurance coverage is usually better than no coverage.
Many employers will offer the ability to choose either a Preferred Provider Organization (PPO) dental plan or a Dental Health Maintenance Organization (DHMO or simply, HMO) plan.
Of these two options, let’s address the HMO plan first. An HMO plan may be reasonable if you only require seeing your dentist twice per year for routine cleanings. In such a case, HMO plans are attractive since they tend to have slightly lower monthly premiums.
However, most HMO plans do not offer coverage for dental implant expenses. What good is an HMO plan to you if it doesn’t cover the more costly procedures you need?
When it comes to insurance coverage for dental implants, PPO plans are the better of the two options. The overwhelming majority of dental insurance plans are now PPO plans, not HMO.
While PPO insurance plans have not always covered dental implant expenses, more and more now PPOs provide partial coverage.
Keep in mind PPO dental insurance plans will often have $1,000 to $2,000 annual maximums. A single dental implant, including the surgery and final crown, can cost as much as $5,000.
Therefore, you should not expect your PPO insurance plan to cover the total cost of your dental implant procedure. As mentioned earlier, some coverage is better than none at all.
Given the way dental insurance works, your open enrollment choices should be based around securing some dental implant coverage. It is very rare that dental insurance will cover the majority of your dental implant expense.
For a more in-depth explanation of the difference between a PPO and DHMO, please visit the Delta Dental website.
For the record, indemnity insurance is a third form of dental insurance that may be available to you. Indemnity dental insurance works very similar to a PPO and may offer you slightly more coverage than a PPO option. However, most employers no longer offer indemnity dental insurance plans.
2. Opting into a flexible spending account
Now that we’ve addressed insurance, let’s look at the option of a healthcare flexible spending account (Health FSA plan) next. If you intend to receive dental implant treatment in the coming year, participating in your employer’s FSA plan is a wise choice.
Just what exactly is a Health FSA fund? We won’t go into extensive detail here, but for a comprehensive breakdown on Health FSA plans, you may find this SHRM article helpful.
Essentially, a Health FSA plan allows you to set aside a designated portion of your pre-tax income. These designated funds are automatically withdrawn from your paycheck and deposited into your Health FSA plan. You can then use these FSA funds to pay for medical and dental procedures using pre-tax dollars.
For the 2023 calendar year, the IRS will allow an employee to contribute up to $3,050 to an FSA fund, tax-free. This is up from $2,850 in 2022.
Many FSA plans will allow you to spend your total planned contribution amount at the beginning of the new FSA fund year. Therefore, if you begin contributing in January of 2023, your FSA plan may allow you to spend your total planned contribution amount, as early as January 2023.
The below table is an example of two total contribution amounts. Employee A contributed $1,000 and employee B chose to contribute $3,050 into their FSAs for the year. Assuming employees A and B are paid on the 1st and 15th of each month (24 pay periods per year), only 1/24 of their annual contribution will be withdrawn from each of their paychecks.
Employee | FSA planned contributions | Number of pay periods | FSA contribution per pay period |
A | $1,000 | 24 | $41.67 |
B | $3,050 | 24 | $127.08 |
Since employee A opted to contribute $1,000 total, only $41.67 will be withheld from each paycheck. And because employee B chose to contribute the maximum of $3,050 for the year, $127.08 will be withheld from each paycheck.
In essence, FSA plans allow you to establish a payment plan over the course of a year for out-of-pocket expenses not covered by your dental or medical insurance. The previous section should make it easy to see that whether you have dental insurance, you will likely incur out-of-pocket expenses to cover the total cost of your dental implant procedure.
If your employer offers an FSA plan, and you need implant treatment, it may be worth taking advantage of it. You’re likely to spend this income on dental implant treatment anyway. You may as well use an FSA to manage this budgeting process for you, throughout the course of a year, tax-free!
3. Considering funding a health savings account
If your employer offers a health savings account (HSA), you should consider participating. If you know you will need dental implant treatment in the coming year, this option can go a long way to help make your dental implant therapy affordable.
In some ways, an HSA plan is similar to the previously discussed Health FSA plan. As with an Health FSA plan, the following is also true of an HSA plan:
- Contributions made to an HSA plan are withheld from an employee’s paycheck each pay period.
- HSA contributions are pre-taxed income.
- HSA funds may be used for approved medical and dental procedures.
In 2023, the maximum contribution the IRS will allow an employee to deposit into an individual HSA plan is $3,850. This is up from $3,650 in 2022. The maximum contributions for a family plan is limited to $7,750, up from $7,300 in 2022.
One unique benefit of an HSA plan is that the federal government allows the employer to also contribute to an employee’s HSA plan.
A second unique benefit to an HSA is that unused contributions may be rolled over for use in coming years.
Considerations for opting into an HSA plan includes:
- You must first choose to participate in a High Deductible Health Plan (HDHP) or a Consumer Direct Health Plan (CDHP).
- Employees choosing to participate in either an HDHP or CDHP program may opt to participate in a Limited Purpose FSA plan in lieu of the aforementioned Health FSA plan. (The 2023 maximum allowable contribution to a Limited Purpose FSA plan is $3,050.)
Depending on your individual or family medical needs, it may or may not be worth opting for a HDHP or CDHP plan.
You are not alone if this all seems confusing to you. It is advisable that you speak with your human resources department. Your HR manager can discuss the specific pros and cons of an HSA plan in detail. It may be a great opportunity to make your dental implant treatment affordable.
Open enrollment choices can make a difference in dental implant affordability
The dental insurance coverage choices you make during your benefits open enrollment period can mean the difference between insurance that pays a portion of your dental implant treatment or one that does not.
If you need multiple dental implants – as with the TeethXpress full-mouth implant procedure – you may benefit from reaching your total dental insurance maximum.
Between completely funding an HSA ($3,850) and a Limited Purpose FSA ($3,050) for a combined total of $6,900, you are well on your way to budgeting your dental implant needs for 2023, tax-free.
Couple this with a potential $2,000 dental insurance maximum coverage, and as much as $8,500 may be available to help you meet your dental implant needs.
Be sure to discuss your options with your human resources department since plans vary from company to company. It is worth having the discussion.
For more dental implant payment plan options that can help make your treatment more affordable, visit Cost of Dental Implants.
