Use It or Lose It: Make the Most of Your PPO Dental Benefits Before December 31

If you have a PPO dental plan, benefits you do not use by December 31 usually disappear on January 1. Your yearly maximum and deductible start over, and unused benefits do not roll over. PhD Dental accepts all PPO plans, plus Medi-Cal and Denti-Cal, at offices across Greater Los Angeles — so if you have been putting off a checkup or treatment, October and November are the smartest months to book.

Do PPO dental benefits roll over to next year?

No. Most PPO dental plans reset on January 1. That means your annual maximum starts over, your deductible starts over, and any benefits you did not use this year are gone. You have already paid premiums for this year’s coverage all year long — using it before it resets is simply getting what you paid for.

What should I schedule before December 31?

Start with an exam and cleaning if you have not had one this year. A checkup lets your dentist catch small problems while they are still small — a tiny cavity, early gum irritation, or a worn filling that has not started hurting yet. It also tells you whether there is anything else worth finishing before your benefits reset, such as:

• A filling for a cavity that does not hurt — yet
• A crown for a cracked or heavily filled tooth
• Treatment for sore, swollen, or bleeding gums
• A root canal for a tooth that aches or is sensitive to hot and cold
• Replacing a missing tooth

Waiting rarely makes these problems smaller. A cavity keeps growing, a cracked tooth can break further, and gum disease does not go away on its own.

Visiting family from out of town, or do not have insurance? At PhD Dental, an exam with full x-rays costs $69 if you do not have insurance. A basic cleaning starts from $125 and includes fluoride; if you have periodontal disease (an infection of the bone around the teeth), a deep cleaning can cost a few hundred dollars, depending on your diagnosis.

Which dental insurance plans does PhD Dental accept?

We accept Medi-Cal. We accept Denti-Cal. We also accept these PPO plans: Aetna PPO, MetLife PPO, Delta Dental PPO, Cigna PPO, Guardian PPO, UnitedHealthcare PPO, Anthem Blue Cross PPO, Blue Shield of California PPO, Humana PPO, Principal PPO, Ameritas PPO, United Concordia PPO, Sun Life PPO, Lincoln Financial PPO, Unum PPO, The Hartford PPO, Renaissance Dental PPO, Premier Access PPO, and Health Net PPO. Please note we do not accept any HMO plans at this time. If you are unsure what your plan covers, call one of our offices and we would be more than happy to help you check.

What if I need bigger treatment, like a crown, an implant, or braces?

Plan the timing — some treatment takes more than one visit, which is another reason not to wait until the last week of December. A crown, for example, is prepared and fitted with a temporary at your first visit; the final crown is custom-made for your tooth and placed at a second visit.

Our oral surgeon, periodontist who places dental implants, and orthodontist see patients across our PhD Dental offices on scheduled days — so advanced care is always within reach, here or at a nearby PhD Dental office. An end-of-year consultation is a good first step: orthodontic consultations are available, and your dentist can help you plan treatment so you use the benefits you have left this year and the new benefits that begin in January.

What if I have tooth pain right now?

Do not wait for a benefits deadline. Tooth pain, swelling, a broken tooth, or a lost filling or crown needs prompt attention. Walk-ins are welcome at all of our offices, and we offer same-day appointments when available. Call the office closest to you as early in the day as you can, and our team will do its best to get you seen promptly.

What if I do not have dental insurance?

You can still get care. The $69 exam with full x-rays gives you a clear picture of what you need, and we offer in-house payment plans and financing options so you can decide with real numbers instead of guessing. Call us and ask — we will explain your options before any treatment begins.

Common questions

Do dental benefits expire at the end of the year?

For most PPO plans, yes. Unused benefits do not roll over, and your maximum and deductible reset on January 1.

How much does a dental exam cost without insurance at PhD Dental?

An exam with full x-rays costs $69. A basic cleaning starts from $125, including fluoride.

Does PhD Dental accept Medi-Cal or Denti-Cal?

Yes. We accept Medi-Cal. We accept Denti-Cal. Dental coverage for Medi-Cal members runs through Medi-Cal Dental (Denti-Cal).

Does PhD Dental accept HMO plans?

No. We do not accept HMO plans at any of our offices.

Can I start treatment this year and finish it next year?

Often, yes — and it can be the smartest way to use two years of benefits for one larger treatment plan. Ask your dentist to map out the timing at your visit.

Book your visit before your benefits reset

The most common mistake we see is waiting too long to call. Schedules fill up as December approaches, and treatment that needs more than one visit needs time built in. A call in October or November gives you options; a call in the final days of December may not.

Call your nearest PhD Dental office today or book online through phddental.com. Our offices are in Los Angeles, Inglewood, Lynwood, Pico Rivera, Compton, Westchester, and Norwalk, and we look forward to helping you end the year with a healthier smile.