With the holidays around the corner, it’s a good time to take a quick look at your dental insurance before year end. Many group plans reset their annual maximum on January 1, and unused benefits generally don’t carry over to the next year. Here’s a simple guide from the Chez Soie dentisterie team in Vaudreuil-Dorion to help you plan your care, whether you live in Vaudreuil, Île-Perrot, Pincourt or the West Island.
How dental insurance year end works
Most private dental plans (through your employer, union, professional association or an individual policy) are built around a few basic rules, often calculated on a calendar year:
- Annual maximum: the total amount your insurer will reimburse per person for the year. Unused amounts usually don’t roll over.
- Deductible: what you pay before your coverage kicks in. If you’ve already paid it this year, it will also reset in January.
- Coverage percentage: often different for preventive, basic and major services.
- Frequency limits: for example, an exam or cleaning covered once every 6, 9 or 12 months, depending on your contract.
Keep in mind that some plans renew on their policy anniversary date (July 1, for instance) rather than January 1. Your benefits booklet or your insurer’s app will tell you which applies to you.
Care worth scheduling before December 31
Checkups and cleanings
If your last preventive visit was a while ago, now may be the time to book your dental examination and scaling and polishing. Regular visits help detect cavities and gum problems early, often before you feel any pain. Depending on your situation, the dentist may also recommend digital X-rays.
Treatment that was recommended but never done
A small cavity, an old filling that needs replacing, a cracked tooth? If treatment was already recommended at a previous visit, the end of the year is a good time to get it done. A filling done early is generally simpler than waiting until the problem progresses.
Major work: crowns, root canals and more
Larger treatments, such as a crown or a root canal treatment, can use up a big part of your annual maximum. In some cases, when it makes sense clinically, a treatment plan with several steps can be spread across two benefit years. Ask the dentist about it: your oral health always comes first.
Night guards
Do you clench or grind your teeth at night? A custom-made mouthguard is one way to protect your teeth from wear caused by bruxism. Many plans cover part of the cost, so check with your insurer.
What about cosmetic treatments?
Cosmetic services like teeth whitening are generally not covered by dental insurance. If you’re thinking about it for the holidays, the dentist will first check the health of your teeth and gums before suggesting an option that suits you.
Your year-end dental benefits checklist
- Check your balance. Log in to your insurer’s app or portal to see how much you’ve used and what’s left for each family member.
- Confirm your renewal date. Calendar year or policy anniversary? It changes your whole plan.
- Look at frequency limits. Has enough time passed since your last exam or cleaning for it to be covered?
- Ask for a pre-determination for major work. Before a crown or a denture, we can give you a detailed treatment plan to send to your insurer, so you know ahead of time what will be reimbursed.
- Call early. The weeks before the holidays tend to be busier at dental clinics. Booking in November gives you more choice of appointment times.
Two plans in the family? Coordinate your benefits
If you’re covered by your own plan and your spouse’s, coordination of benefits may allow you to claim the unpaid portion from the second insurer, depending on both contracts. For children, the order in which the two plans are billed also follows specific rules that your insurer can explain.
Covered by the Canadian Dental Care Plan?
The Canadian Dental Care Plan (CDCP) doesn’t follow the calendar year: its benefit period runs from July 1 to June 30, so December 31 has no special effect on your coverage. Also keep in mind that the CDCP reimburses according to its own fee grid, which isn’t aligned with Quebec fees. In most cases there will be a balance to pay, even if your co-payment is 0%.
No insurance? Your care still matters
If you don’t have dental insurance, year end isn’t a deadline for you, but regular checkups remain the best way to keep your mouth healthy. Feel free to ask for an estimate before any treatment: our team will take the time to explain your options and costs. The Ordre des dentistes du Québec also offers useful information for patients.
Frequently asked questions
Does my unused annual maximum carry over to next year?
Usually not. Most private plans reset the maximum at the start of each benefit year. Some contracts have special rules, so check your benefits booklet.
Does my plan year always start on January 1?
Not always. Many plans follow the calendar year, but others renew on the policy anniversary date. Your insurer or HR department can confirm it.
What is a pre-determination?
It’s an estimate sent to your insurer before major treatment. The insurer tells you how much it will reimburse, so you can plan your budget with no surprises.
Is teeth whitening covered by insurance?
Whitening is a cosmetic service and is generally not covered by dental plans. It’s best to check your own contract.
My child is under 10. Do I need to use my insurance?
In Quebec, the RAMQ covers several dental services for children under 10, such as the annual exam and X-rays. Some services, like cleanings and fluoride, aren’t covered by the RAMQ and may be claimed from your private insurance, depending on your plan.
Plan your care with Chez Soie dentisterie in Vaudreuil-Dorion
Want to make the most of your dental insurance before year end, or follow up on a treatment that was recommended? Our family team welcomes you at the Polyclinique médicale, 600 Harwood Boulevard, Vaudreuil-Dorion, just minutes from the West Island. Call us at 450 455-5671 to book your appointment.
This article is for informational purposes only and does not replace a consultation with a health professional. Coverage details vary from one insurance contract to another.
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