Use Your Dental Benefits Before They Reset on January 1

By the team at Mark Bilello, DDS. 5 min read

Most dental plans give you a set amount of coverage each plan year. When the plan year ends, that amount starts over, and for many plans the reset date is January 1. To use dental insurance before the end of the year, find out what you have left, book any checkup you have not had yet, and ask about any treatment that is already planned.

What are an annual maximum and a deductible?

An annual maximum is the most your dental plan will pay toward your care in one plan year. The American Dental Association (ADA) describes these limits as caps that restrict how much a plan will pay per year [1]. Once your plan has paid that amount, you pay the rest until the plan year starts over.

A deductible is the amount you pay for covered care before your plan starts to pay its share [2]. If you have already met your deductible this year, your plan is already paying its share on covered care. When the new plan year begins, ask your insurer whether your deductible starts over too.

Why do many plans reset on January 1?

Many dental plans follow the calendar year, so the annual maximum and deductible start fresh on January 1. Not every plan works that way. Some use a plan year that begins in a different month, so check your benefit summary or ask your insurer which dates apply to you.

What happens to money you did not use depends on your plan. Some dental plans roll part of a member’s unused benefit into the next year, according to the National Association of Dental Plans [3]. If yours does not, the unused part of this year’s maximum does not carry forward.

What preventive visits do plans commonly cover?

Many plans pay the largest share for preventive care. The ADA notes that a familiar plan design pays 100 percent for preventive care, 80 percent for basic services and 50 percent for major services [1]. Your plan’s numbers may be different.

Preventive care often includes checkups and cleanings. For tax purposes, IRS guidance also counts sealants and fluoride treatments as preventive care [4]. Your plan may limit how often it pays for each one, so look for the frequency rules in your benefit summary.

How often you should visit is a separate question from what your plan pays. The ADA says some people need to see the dentist once or twice a year, and others may need more visits [5]. Your dentist can suggest a schedule that fits your mouth.

What should you do if you already have treatment planned?

If your dentist has recommended treatment, find out how much of this year’s maximum is left before the year ends. Then ask your dentist whether the work should be done now or could be split across two plan years. Splitting can let you use benefits from both years, but only your dentist can tell you whether waiting is safe for that tooth.

These steps can help:

1. Ask for your treatment plan in writing, with the name of each procedure.
2. Ask your insurer what your plan may pay toward it and whether a waiting period applies.
3. Ask whether your insurer offers an estimate before treatment.
4. Book soon, so there is time to fit visits in before your plan year ends.

You can learn more about fillings, crowns and other everyday care on our general and restorative dentistry page.

How do FSA and HSA rules work at the end of the year?

A flexible spending account (FSA) is generally “use it or lose it.” Money left in the account at the end of the plan year is forfeited, according to the IRS [6]. Your employer may give you a grace period of up to two and a half months, or let you carry over a limited amount, but a plan cannot offer both [6].

FSA money can pay for certain dental expenses for you, your spouse and your dependents [7]. The IRS list of dental expenses that count as medical care includes cleanings, X-rays, fillings, braces and dentures, but not teeth whitening [4].

A health savings account (HSA) works differently. Money left at the end of the year generally carries over to the next year [6]. You can only put money into an HSA if you have an HSA-eligible high-deductible health plan [8]. Ask your employer or benefits administrator for your FSA deadline and which rule your plan uses.

How do you check how much of your benefits are left?

Call the member services number on your insurance card, or log in to your insurer’s member website. Have your card ready and ask:

• What is my annual maximum, and how much have I used?
• Have I met my deductible this year?
• When does my plan year end?
• Does any unused benefit roll over?
• How often does my plan pay for exams and cleanings, and when was my last one counted?
• Do any waiting periods apply to the care I have planned?

Your dental office can help too. Call our office with your plan details and we can talk through your visit and payment options; we also offer third-party financing through CareCredit.

What should be on your year-end checklist?

• Find your plan year end date.
• Check how much of your annual maximum is left.
• See whether you have met your deductible.
• Book any checkup or cleaning your plan still covers this year.
• Ask your dentist about treatment that is already planned.
• Check your FSA deadline and whether it has a grace period or carryover.

FAQ

Does my unused annual maximum roll over?
It depends on your plan. Some dental plans roll part of the unused benefit into the next year [3]. Others start over at the same amount each plan year. Your insurer can tell you which kind you have.

Can I use my FSA for a dental visit in January?
Only if your employer’s FSA has a grace period or a carryover. With a grace period, you may have up to two and a half extra months to use last year’s money. With a carryover, a limited amount moves into the new year [6].

Is a December cleaning worth it if I had one this summer?
It may be, if your plan still has a covered cleaning left this year and your dentist recommends one. Check your plan’s frequency rules before you book.

Do I have to use my benefits before the year ends?
No. The year-end date only matters if there is care you need and coverage left to put toward it.

Have questions about using your benefits before the year ends? Mark Bilello, DDS, in Houma can help. Send us a request through our contact page.

Sources

1. American Dental Association, ADA News, “Dear ADA: Annual maximums,” December 2025. https://adanews.ada.org/ada-news/2025/december/dear-ada-annual-maximums/
2. HealthCare.gov, “Deductible” (glossary). https://www.healthcare.gov/glossary/deductible/
3. National Association of Dental Plans, Mike Adelberg, “An Under-Appreciated Truth: Consumer Protections in Dental Plans Are Increasing,” July 20, 2023. https://www.nadp.org/an-under-appreciated-truth-consumer-protections-in-dental-plans-are-increasing/
4. IRS, Publication 502 (2025), Medical and Dental Expenses, “Dental Treatment.” https://www.irs.gov/publications/p502
5. American Dental Association, MouthHealthy, “Common Questions About Going to the Dentist.” https://www.mouthhealthy.org/dental-care/questions-about-going-to-the-dentist/
6. IRS, Publication 969 (2025), Health Savings Accounts and Other Tax-Favored Health Plans. https://www.irs.gov/publications/p969
7. HealthCare.gov, “Using a Flexible Spending Account (FSA).” https://www.healthcare.gov/have-job-based-coverage/flexible-spending-accounts/
8. HealthCare.gov, “Health Savings Account (HSA)” (glossary). https://www.healthcare.gov/glossary/health-savings-account-hsa/