If you have PPO dental insurance, through work or on your own, it most likely runs on a calendar year. On January 1 the plan starts over: whatever you didn't use this year doesn't carry into the next one.
October and November are the months to review it calmly. In December dental schedules fill up and insurance approvals take longer. This guide covers what resets, what's worth doing before December 31, and how to find out whether your plan covers you at our Kendall office.
It's the most your insurer will pay for you in a year. Every plan sets its own. If you've barely used it this year, that room disappears on December 31: it does not roll over.
It's what you pay before the plan starts paying for basic and major services. If you've already met it this year, finishing treatment before year-end usually works out better than starting in January with the deductible due again.
Many plans cover two cleanings and two exams a year, plus X-rays on a set schedule. If you're missing your second 2026 cleaning, there's still time.
The upside of a PPO is that you can choose your dentist. If the dentist is in-network, the insurer has already agreed on fees and you pay only your share. If the dentist is out-of-network, many PPOs still pay something, but usually less, and you cover the difference.
That's why the first thing we do is check your plan: we tell you whether we're in or out of your network, what's covered and how much you have left, before booking anything.
If the plan covers your spouse and kids, check each person. Children's cleanings, sealants and checkups have yearly limits too. Orthodontics usually has its own lifetime maximum that works differently from the annual one: ask about it if you're considering braces or aligners.
In the last weeks of the year many people try to use their insurance at once, and major treatment (crowns, bridges, dentures) usually needs pre-authorization: the insurer has to approve it in writing before work starts, and that takes time. Checking now leaves room for everything.
PureSmile Miami opens November 1, 2026 at 8000 SW 117th Ave, Suite 100, Kendall. We work with PPO insurance and Medicare Advantage plans, and we see you in English or Spanish.
Call us at (305) 787-3642 or leave us your details: we'll check your insurance for free and tell you what you still have to use this year.
No. On almost every plan the annual maximum resets when the plan year starts, usually January 1. What you didn't use is lost.
Most do, but some employer plans run on a plan year and reset in another month. It's in your summary of benefits, or the number on your card can tell you.
Generally yes: dental treatment is usually an eligible expense. Confirm with your employer or account administrator.
Many PPOs let you see any dentist, in or out of network. Before your visit we check your plan and tell you exactly how it covers you at our office.
