If you have dental coverage through work, there is a good chance it runs on the calendar year. That means on January 1 your annual maximum resets, and anything you did not use in 2026 is gone. It does not roll over, and it does not get refunded. October is the right time to check where you stand, because by December most dental offices, including ours, are booked solid.
How dental benefits work, in plain terms
Most private dental plans in Ontario have four moving parts.
Annual maximum. The most your plan will pay in a benefit year. Once you reach it, you pay the rest yourself.
Deductible. An amount some plans ask you to pay before coverage starts each year. Not every plan has one.
Coverage percentage. Plans usually pay a different share for different types of care: a high percentage for preventive care like cleanings and checkups, a lower one for basic care like fillings, and a lower one again for major care like crowns.
Frequency limits. Rules about how often something is covered, for example one checkup every 9 or 12 months, or X-rays every few years.
Two plans in the family? If you and your spouse or partner both have workplace coverage, you can often claim under both. Your own plan pays first and the other plan may pick up some or all of the rest, which is called coordination of benefits. Children are usually claimed first under the plan of the parent whose birthday comes earlier in the year. Before the year ends, it is worth checking both balances, not just yours, so the treatment gets billed in a way that makes the most of both plans.
Your plan booklet or your insurer’s app shows all four. If you are not sure where to look, bring your plan details to your appointment and we will check for you.
What resets on January 1, and what does not
On a calendar-year plan, your annual maximum and your deductible reset on January 1. Frequency limits are often counted on a rolling basis instead, so a checkup you had in March may still count against you in February. Some plans run on a policy year that starts in a different month, so check your booklet before assuming.
What does not reset: the orthodontic lifetime maximum. If your plan covers part of braces or Invisalign, that coverage is usually a one-time amount for life, not a yearly one. That matters if you are considering Invisalign, because how the payments fall across the year can affect how much your plan pays.
Three ways to use what you have left
1. Book your cleaning and checkup. If it has been more than six months, or your plan allows another visit before December 31, this is the easiest win. Preventive care is usually covered at the highest percentage. Here is what to expect at a dental cleaning and checkup at Longo Dentistry.
2. Finish treatment that was already recommended. If a dentist mentioned a filling, a crown or a replacement for an old restoration, getting it done this year uses this year’s maximum. Waiting until January uses next year’s, and small problems tend to get bigger while you wait.
3. Plan bigger treatment across two benefit years. For treatment like Invisalign, a veneer on a tooth damaged by trauma, or several crowns, starting before the end of the year can let part of the cost fall in 2026 and part in 2027. Whether that works depends on your plan and the treatment, so ask us to send a predetermination to your insurer first. It is free, and it tells you in writing what the plan will pay before you commit. Read more about our cosmetic dentistry options, including Invisalign and veneers.
Why waiting until December is a gamble
December is one of the busiest months in most dental offices. Everyone has the same idea at the same time, the office closes for part of the holidays, and some treatment needs two visits a few weeks apart. If you book in October or early November, you have room to finish everything before the reset. If you book in mid-December, you may run out of days.
What about the Canadian Dental Care Plan?
The Canadian Dental Care Plan (CDCP) works differently. It is a federal plan for people who do not have access to dental insurance, and it runs on a benefit year from July 1 to June 30, so nothing resets on January 1. Applications are open for the 2026-27 benefit year. If you have no dental insurance and filed a tax return last year, it is worth checking whether you qualify at Canada.ca or by calling 1-833-537-4342. Our CDCP guide for London, Ontario walks through it step by step.
Longo Dentistry accepts the CDCP with direct billing, so we bill the plan for covered services and you are not paying the full amount up front and waiting to be reimbursed.
How we help at Longo Dentistry
Bring your plan details or your insurer’s card to your appointment. We will check what you have left for 2026, send a predetermination for any larger treatment, and bill your plan directly where we can. We have Saturday appointments and one weekday evening for anyone who cannot get away during the workday.
Frequently asked questions
Do dental benefits roll over to the next year?
Usually not. On most private plans, unused annual coverage ends on the last day of the benefit year. Check your plan booklet to confirm when your benefit year ends.
How do I find out how much coverage I have left?
Your insurer’s app or member website usually shows your remaining balance. You can also call the number on your benefits card, or ask us to check at your appointment.
Is it worth starting Invisalign before the end of the year?
It can be, if your plan has orthodontic coverage and the payment schedule lets part of the fee fall in each year. A predetermination will show you before you commit.
Does the CDCP reset on January 1?
No. The CDCP benefit year runs from July 1 to June 30, so January is not a deadline for CDCP members.
Book before the rush
If you have benefits left for 2026, now is the time to use them. Call Longo Dentistry at (519) 455-1221 or book online. We are at 1221 Dundas Street, Unit 1, in Old East Village, and new patients and families are welcome.
