Alexandria, VA

Dental Insurance

Dental Insurance

Dental insurance is a form of health insurance designed to cover some of the costs of standard dental care. Fortunately, compared to health insurance, dental insurance is relatively easy to understand. Dental insurance is also available either as a standalone policy or part of a larger medical insurance plan. If you are looking for a new dental insurance plan, make sure you know the different options before making your final decision. No matter what choice you make, we at Alexandria Old Town Dental are here for you. We are proud to serve patients in Alexandria and the surrounding area.

  • How Dental Insurance Works

    According to Investopedia, patients should choose a dental insurance plan based on two factors: the network of dentists they want to access and the amount they can afford to pay. Patients can also see dentists who are out of network, but this tends to be a significantly more expensive option. Monthly premiums will vary depending on the patient's insurance company, location, and plan.


    There is also a waiting period for most dental insurance policies – usually, around six to 12 months before the patient can have any standard work done. Major work may require longer waiting periods up to two years long. When it comes to dental insurance, there are typically three categories of coverage: preventative, basic, and major. Most plans cover 100% of preventative care, 80% of basic procedures, and 50% of major procedures.

  • Finding the Right Dental Plan

    When selecting a dental insurance plan, people should consider several factors to find a plan that best suits their needs. The first step to finding the right dental plan involves evaluating needs. Young, single adults with good dental health and no family history of oral problems will have different dental insurance needs than a family with a parent who has a family history of gum disease. The likelihood of more frequent visits to the dentist and more extensive treatments indicates the need for a more comprehensive dental insurance policy. Making a generalized list of dental and oral health needs can serve as a good benchmark for evaluating policies and anticipating overall costs.


    It is also important to understand the different types of dental insurance plans since each will have varying out-of-pocket costs, benefits, deductibles, and more. Typically dental plans are divided into Preferred Provider Organizations (PPO), Dental Health Maintenance Organization (DHMO), discount dental plans (DDP), and Managed Fee-for-Service Plans. Once people determine the available plans, they should also consider their budget and the covered procedures, waiting periods, and annual limits. Taking the time to evaluate dental needs, budget, and anticipated level of care can make choosing the right dental plan easier.

Dental Coverage

No matter what dental plan a patient chooses, it is essential to double-check what services are included. Some of the most common dental services patients want are routine preventative care and orthodontic services. Though most dental plans cover routine services, they may also require a copay or a fixed amount a patient pays for a health service after meeting their deductible. However, not all dental plans include coverage for orthodontic services and other specialized services. Therefore, it is imperative to read the details of each plan carefully. Patients who are unsure of the details of their plan should call their insurer to clarify any questions they may have so they are prepared for all scenarios.

  • Affordable Care Online Enrollment

    The Affordable Care Act (ACA) is a comprehensive healthcare reform intended to extend health insurance coverage to millions of uninsured Americans by legally requiring them to buy health insurance. It does not cover dental coverage for adults, but it does mandate that dental insurance is available to families with children. Adults do not have to buy coverage for themselves.


    People can get dental coverage either as part of a health plan or by themselves through a separate, stand-alone dental plan. People interested in enrolling should create an account and apply for a plan during open enrollment. They can also browse plans on healthcare.gov to determine whether you qualify for a special enrollment period.

  • Dental Insurance Through Employers

    Most dental insurance plans follow the 100-80-50 coverage structure. That means the plan covers preventative care at 100%, basic procedures at 80%, and major procedures at 50%. Sometimes major procedures have a larger copayment. Some dental plans do not cover some procedures, so people must check with their insurance provider for more information.


    Employer-sponsored health insurance is the primary source of coverage for people in the United States. People should carefully read the details of an employer's dental insurance plan to determine whether the care they require is covered and at what percentage. Call the insurance provider directly with any questions or concerns.

  • Dental Insurance Fees

    Like health insurance plans in the United States, dental insurance plans come with costs, such as deductibles and copays. A deductible is a minimum amount that a person must pay before the insurance policy pays for anything. The deductible will vary depending on the type of dental insurance. Once the patient pays the deductible, their insurance plan will pay for the remaining costs.


    Patients may also have to pay a preset amount, called a co-pay, before receiving a service or treatment covered by your insurance provider. The co-pay is usually due to the dentist at the time of the service. People will have to pay it even after they reach their deductible.

When to Spend Your HSA

The cost of healthcare can be intimidating. Luckily, there are ways to save on insurance and out-of-pocket costs. A healthcare savings account is one strategy to help offset the cost of medical and dental expenses. Patients with healthcare savings accounts can use them for dental services at Alexandria Old Town Dental in Alexandria and the surrounding area. Our team works with clients to determine the optimal financial strategy for treatment.

  • Using HSA as an Investment Tool for Retirement

    An HSA is a great investment tool for retirement because of its tax treatment. It is one of the most tax-efficient investment options for people to save for retirement. Having an HSA offers greater investment growth potential and after-tax balance accumulation than other retirement options.


    A crucial part of a retirement plan includes making regular contributions to an HSA to cover medical expenses in the future. People should consider the number of years between now and retirement. Some people may watch to take advantage of catch-up contributions as they approach retirement. While people can use their HSA for quali?ed medical expenses like dental care, retirees can also use their savings to pay for any non-qualified medical expenses once they reach age 65.

  • HSA Tax Benefits

    One of the greatest benefits of opening an HSA is its lower tax liability. Lowering tax liability with an HSA allows people to keep more of their paycheck each year and give less to the IRS. Benefits to opening and contributing to an HSA include:


    • Contributions: The money contributed to an HSA is not taxed. Some people set their accounts up so that contributions are automatically taken out of their pay each month. The HSA withdraws the contribution before taxes, so it does not count as income and lowers the yearly tax liability.
    • Earnings: An HSA account can earn interest. Earnings on an HSA account are also tax-free. The larger an HSA balance is, the more tax-free earnings it can get.
    • Withdrawals: When it is time to use a portion of the HSA account, withdrawals are also not taxed. People can use their withdrawals for any type of qualifying medical expense. There is no need to time medical expenses by the calendar since an HSA does not need to be spent by the end of the year.
  • Spend On Little Things and Invest For Later

    People can maximize the value of their HSA by investing and saving wisely. Due to HSA's tax efficiency, people with an HSA may want to consider contributing the maximum amount and pay for small current health expenses through other sources. Treating an HSA as an investment account can help people prepare for retirement and bigger expenses later on.


    Since the funds in an HSA grow tax-free, it is best to leave account savings for as long as possible to grow. Investing in stocks, bonds, and mutual funds can help grow the balance and maximize retirement earnings. The amount of time until retirement will determine how aggressive or conservative to be with fund selection.

  • Transferring an HSA When Changing Jobs

    When changing jobs, there is a procedure for transferring the HSA to the next employer. The rules of transferring an HSA are dependent on the employer-sponsored health insurance plan. If the new workplace does not offer a high-deductible health plan, the employee may not be eligible for making contributions to the HSA anymore.


    It may be necessary to roll over the funds from one HSA account to another when transferring to another employer-sponsored HSA. Another option is to keep the old account open and start a second HSA with the new employer. While the old HSA will not be available for contributions, people can still use it for withdrawals.

  • The Right Time To Open an HSA

    As long as a person is qualified, it is possible to open an HSA at any age. However, it may be beneficial to open an HSA at a younger age because of the power of time. Investing early on gives people the ability to have their contributions compound tax-free for longer. People should start saving with an HSA when they are young and healthy with lower health care costs.


    Early on in their careers, people do not have to save a large amount to their HSA since there is no minimum contribution. However, saving money in an HSA while young can help people get the most out of their long-term retirement savings. We recommend developing an investment and savings strategy as early as possible.

Flexible Spending Accounts

Today, many employers offer a flexible spending account (FSA) as part of their benefits packages. Employees can use these funds to set aside money from each paycheck. FSAs cover most out-of-pocket health care expenses, including dental treatments. Alexandria Old Town Dental in Alexandria and the surrounding area accepts FSAs. Our team works with your employer to confirm coverage. If you are confused about using your FSA, we can help you. Do not let your FSA expire.

  • How FSAs Work

    FSAs help bridge any gaps that other health insurance plans leave behind by using tax-free funds to cover out-of-pocket healthcare expenses. At times, they can even help replace a traditional employer-provided health insurance plan. According to Investopedia, funds contributed to an FSA are deducted from the earnings before taxes, thus lowering one's overall taxable income. Consequently, regularly contributing to an FSA may reduce one's annual tax liability.


    FSAs can also help supplement or replace a traditional employer-sponsored healthcare plan. In either case, the FSA's main purpose is to cover out-of-pocket healthcare expenses. These funds can go towards coinsurance, copayments, deductibles, and some prescription and over-the-counter drugs. FSAs can sometimes even go towards medical devices, such as crutches.

  • The Pros and Cons of an FSA

    Tax savings represent the main benefit of an FSA. Since the funds are removed before taxes, employees have a lower taxable income. Some employees find that an FSA increases their take-home pay. The funds in an FSA are available at all times, with few restrictions. Most FSAs are linked to a debit card for added convenience. Patients can then use their FSA debit card at their doctor, dentist, or pharmacy. Patients usually do not need pre-approval or to do other paperwork.


    However, employees can only contribute a certain amount of money each year. For most employees, the limit is $2,750 per year. Spouses can also contribute an equal amount to their own FSA. Additionally, FSA funds are tied to an employer. If an employee changes jobs, they cannot keep their current FSA


    FSAs funds are "use it or lose it." At the end of the year, employees can roll over up to $500. The remaining unused funds are forfeited to the employer. Employees must keep an eye on their FSA balance. It's up to each patient to ensure that they use their funds before they expire.


    Many patients confuse FSAs with health savings accounts (HSAs). These programs are similar, but they have a few key differences. With an FSA, employees can use their funds as a line of credit. With HSAs, employees can only spend money they have already saved. HSAs are also transferrable: employees can keep their HSAs if they change jobs.

  • Saving Money With an FSA

    An FSA allows employees to set aside a certain amount of money from each paycheck. At most workplaces, enrollment in an FSA is available for only a limited amount of time. Employees should consult their employers for the full details on how to sign up for an FSA. It is also important to determine how much money they plan to save during the enrollment period.


    Underestimating how much money one should save may cause one to miss out on tax savings, while overestimating may cause one to lose money. As such, each individual must consider their unique circumstances. Once they have enrolled, the set amount of money will be deducted from each paycheck. Funds expire on March 15 of the following year.

  • How to Use FSA Funds

    Patients can use their FSA to cover most dental expenses, including routine care. But not all procedures and treatments are eligible. Before scheduling a dental procedure, patients should talk to their employer and plan provider. Cosmetic procedures, including cosmetic orthodontics, are usually not covered under an FSA. However, if a patient needs orthodontics for medical purposes, they might be allowed to use their FSA funds. Our dental team can work with your plan provider to determine coverage.

  • Treatments Covered by an FSA

    FSAs cover most preventative and diagnostic procedures, along with certain medical devices. However, some exceptions may apply. FSAs are commonly used for things like:


    • Coinsurance
    • Copays
    • Deductibles
    • Eye surgery
    • Eyeglasses
    • Hearing aids
    • Hospital expenses

    They also cover several kinds of dental services, such as:


    • Crowns, bridges, and dentures
    • Diagnostic and preventive care
    • Filling, sealants, and extractions
    • Gum disease treatment
    • Oral surgery
    • Routine cleanings

    Employees should contact their employer and plan provider with any questions and concerns they have about rules and exemptions regarding their FSA. They will also need to find out what is not covered under their plan.

FAQs

  • Is dental health really that important?

    Yes. Many people mistakenly underestimate the importance of oral health. However, it is intrinsically linked to overall health. Neglecting one's oral health may have disastrous effects overall.

  • What questions should I ask while looking for the right dental insurance plan for me?

    There are a few things to keep in mind when looking for dental insurance plans. For example, if you anticipate needing a procedure in the future, make sure to ask whether it will be covered under your insurance. You should also ask if you can see any dentist of your choosing or if you must select one within the provider network, whether you can change dentists once you are enrolled, and how many people the plan will cover. Other pertinent information includes the deductible and copay costs and whether the plan is rated highly by an independent rating firm.

  • What is a discount dental plan (DDP)?

    A discount dental plan (DDP) is an untraditional insurance plan where the patient pays the cost of treatment at the contracted rate as determined by the plan. This type of plan does not involve any claim forms. However, patients must make monthly or annual payments to receive care from providers within the dental network at discounted prices and on a set fee schedule.

  • What are some examples of qualified medical expenses for a healthcare savings account?

    HSA withdrawals are only tax-free when spent on qualifying medical expenses. These include out-of-pocket expenses for doctor visits, medical procedures, co-pays, dental costs, vision care, medications, and feminine hygiene products. The expenses can be for the individual, a spouse, or a dependent.

  • What is a high-deductible health insurance plan?

    To qualify for an HSA, an individual must be participating in a high-deductible health plan. With these, the individual is responsible for paying a certain amount before the health insurance company steps in and starts covering expenses. The deductible needs to be at least $1,400 for an individual plan or $2,800 for a family plan.

  • What is the maximum amount I can put in my flexible spending account?

    While maximum annual contributions may vary, the most you can put into a medical FSA is $2,750. The yearly maximum for a dependent care FSA is $5,000. Ask your employer for more details about your policy.

  • Do my FSA funds roll over?

    It depends on your employer. If you have money left in your flexible spending account at the end of the year, your employer may give you 2.5 more months to spend the money. They may also allow you to carry over up to $500 for the next plan year.

  • Are FSAs the same as HRAs?

    No. Flexible spending accounts (FSAs) are funded by the employee and sometimes by the employer. In contrast, HRAs are funded only by the employer. However, patients can have both accounts at once.

  • Do I actually need a dental insurance plan?

    Yes. Dental healthcare can be costly without insurance, especially if you are keeping up with your routine checkups and cleanings. Choosing the right dental insurance plan can help patients afford preventative dental care.

  • Who should I talk to about my dental insurance plan's benefits or a claim?

    Contact your insurance carrier for any questions and concerns you may have about your benefits or claims. They can access your account to review your benefits, claims activity, and eligibility.

  • How much can I contribute each year to my HSA?

    Each year, the IRS sets a limit on the amount of money someone can contribute to an HSA. For 2021, the limit for an individual is $3,600, and for a family, it is $7,200. Individuals over the age of 55 can contribute an additional $1,000 each year as a catch-up contribution.

  • What are the penalties for withdrawing funds for ineligible purchases for an HSA?

    There is a penalty when using an HSA to pay for things that are not qualifying medical expenses. First, you have to pay taxes on that money as it now counts as income. Next, if you are younger than 65, you are charged another 20% penalty on the funds. To avoid this, do not withdraw HSA funds for non-medical expenses.

  • Who else can contribute to my HSA?

    Some employers also make contributions to their staff's HSA plans. If your job contributes to your HSA, be sure that you do not go over the IRS contribution limit. Excess contributions will result in a 6% tax penalty.

  • What is the difference between a medical FSA and a dependent care FSA?

    As the names suggest, medical FSAs are reserved for medical expenses only. Dependent care FSAs are reserved for dependent care services. The latter include before or after-school programs, child or adult daycare, preschool, and summer day camp.

  • What is the difference between an FSA and an HSA?

    Flexible spending accounts (FSAs) are owned by an employer. Health savings accounts (HSAs) are controlled by an individual. However, both allow employees to save on their medical expenses with pre-tax money.