Between wrapping up projects at work and holiday shopping, it’s the busiest time of the year for many people. That can make it easy to overlook open enrollment and simply roll your dental benefits over to next year or pick a plan without much thought. However, determining the best option for your situation takes more than a couple of minutes. Even if you’re happy with your current benefits or think you only need to add a basic plan, don’t take the decision lightly. Any of these common situations could mean another plan is best for you:
- You're getting married or having kids
- Your child is getting braces
- Someone in your family needs a major dental procedure*
- Your child just started playing sports
- You got a raise
- Your benefits (or your spouse's) are changing
If you’ve experienced changes in these areas of your life, you should think about switching things up.
Most changes to your family circumstances — including the birth or adoption of a child, marriage, divorce, and death — are considered qualifying life events. These events allow you to make changes, usually within a 60-day window, to your health benefits outside of open enrollment. But if you missed the deadline to adjust your policy, now is the time to do so. Having a child or getting married means you may need to add new members to your dental policy and potentially choose a plan with a higher annual maximum to ensure everyone can get care year-round. If you have a child who no longer qualifies as a dependent, get divorced, or experience a death in the family, you may need to cut back on coverage or pick a plan with a lower annual maximum.
Whether you’re adding a new member to your household or not, your dental health should heavily factor into your decision. This could mean choosing a plan with a different premium and deductible. For example, if you plan to undergo a costly major procedure (dental implants, crowns, dentures, oral surgery, etc.), a plan with a higher premium and lower deductible may mean fewer out-of-pocket costs for you.
Give careful consideration to your children, too. While young kids typically need medical care more regularly than dental care, they still require special treatments such as sealants and fluoride, which aren’t fully covered in every plan. Teenagers, meanwhile, often need braces; orthodontic care is a must-add in this situation, as most basic policies don’t cover it. If your child recently started playing a sport with a high risk of mouth injuries, additional coverage for major services may also be beneficial.
On the other hand, if you and your family are in good dental health and rarely use benefits outside of routine checkups and X-rays, you may not need extensive coverage for major procedures. Rather than spending unnecessary money every month, you can potentially choose a more limited plan with a lower premium and higher deductible.
Getting a raise or promotion can open the opportunity to add more comprehensive dental coverage. You could, for instance, move to a higher level of coverage for major procedures to ensure everyone on your plan is covered in case of an emergency. You can also transition to a plan that covers a larger percentage of the cost for procedures that aren’t immediately necessary (e.g., an occlusal mouthguard for bruxism).
Benefits provider or plan
In some cases, your employer may eliminate certain coverage or switch to a provider with plans that don’t fulfill your health needs or financial situation. It may be prudent to join your spouse’s plan if it offers better benefits for you. Similarly, your spouse can add you to their plan if they recently got a new job with better benefits than yours offers.
Even if you don’t fall into any of the above categories, take a little time during the busy holiday season to review changes in your dental coverage and account for life events that necessitate switching to a new plan. A thorough approach to open enrollment will ensure you and your family get adequate care in 2020.