Dental insurance policies work by helping you effectively budget for the cost of maintaining healthy teeth and gums. Dental insurance is available as part of medical insurance plans or as a standalone policy purchased from the Marketplace or a dental insurer. Is dental treatment covered in health insurance? Most health insurance policies do not cover dental treatments because they are considered pre-planned and cosmetic. However, if any dental treatment is required due to an accidental injury or illness and is recommended by doctors as part of the treatment, the medical expenses are covered by insurers. There is no specific dental insurance plan, and few insurance providers offer dental coverage as part of healthcare plans. Fillings, crowns, extractions and surgery are covered but not cosmetic surgeries. If you have opted for out-patient (OPD) coverage, the dental expenses are usually covered, but only those related to extractions, fillings, X-rays, root canal treatments, etc. The cost of dentures, cosmetic surgery, dental prosthesis, dental implants, orthodontics, orthognathic surgery, jaw alignment, etc., are not covered unless necessitated by an accidental injury. Why Do You Need Dental Health Insurance? Here are a few reasons why you need dental health insurance plans: 1. MANAGE DENTAL TREATMENT COSTS: Dental treatments can be expensive, especially if you require complex procedures, such as root canals, extractions, etc. Dental health insurance can help you manage these costs by providing coverage for various dental treatments and procedures. It also provides coverage for unexpected dental emergencies, such as severe toothaches, chipped or broken teeth, or other dental injuries. This coverage can help alleviate the financial burden of unexpected dental expenses. 2. PREVENTIVE CARE: Regular dental check-ups and cleanings are essential for good oral health. Dental health insurance typically covers preventive care services like routine check-ups, cleanings, and fluoride treatments, which can help prevent costly dental problems in the future. 3. COVERAGE FOR PRE-EXISTING DENTAL CONDITIONS: Dental health insurance can provide coverage if you have pre-existing dental conditions requiring ongoing treatment. This coverage can help ensure you receive the necessary care without incurring high out-of-pocket costs. 4. COMPREHENSIVE COVERAGE FOR THE WHOLE FAMILY: Dental health insurance typically offers coverage for the whole family, including dependents. This comprehensive coverage can help ensure that everyone in the family has access to necessary dental care and treatments without worrying about the cost. Features Of Dental Insurance 1. Most health insurance plans do not provide coverage for dental treatment because it is considered cosmetic. 2. Dental insurance typically covers root canal treatment, fillings, extractions, diagnostic tests, oral check-ups, X-rays, preventive care, and any injury due to an accident. 3. Dental treatments done in hospitals under anaesthesia due to injuries, illness, or accidents are covered. 4. Cosmetic surgeries, dentures, implants, jaw alignment procedures, prostheses, and orthodontics are out of coverage. 5. You cannot file any claims during a waiting period. The sum insured is also limited. Benefits Of Health Insurance That Covers Dental Treatments With no standalone dental insurance plans available, you need to compare best health insurance plans based on coverage, benefits, and cost and choose a good plan that covers dental treatments. The advantages offered are: 1. EXPENSIVE DENTAL TREATMENTS WILL BE COVERED: A single visit to your dentist can be quite expensive due to the high cost of most dental procedures. If you have health insurance with dental coverage, you will be financially protected against in-patient dental procedures as well as OPD dental treatments. 2. GOOD ORAL HEALTH: Whether it is for a routine oral check-up or any tooth problems, do you think twice before going to a dentist because it is expensive? A dental insurance plan will take away your financial worries; you can monitor your dental health on a regular basis and keep your teeth healthy. Regular check-ups help avoid and treat issues before they become severe. 3. CASHLESS HOSPITALISATION: If you need to be hospitalised for a few days because of a tooth procedure, you can avail of cashless hospitalisation in any of the network hospitals of the insurance provider. The hospital will receive the payment directly from the insurer. 4. TAX BENEFITS: In addition to the coverage, you can also save money on taxes by availing of tax deductions on your health insurance premium. Copays and Coinsurance Copays are a set dollar amount and also may be required during a procedure. When a dental deductible is met, most policies only cover a percentage of the remaining costs. The remaining balance of the bill paid by the patient is called coinsurance, which typically ranges from 20% to 80% of the total bill. Plans will not have both copays and coinsurance. HMOs usually have copays and PPO plans usually have coinsurance. Annual Maximums Most dental policies cap how much they’ll spend on your dental procedures. Coverage maximums typically range from $1,000 to $2,000 per year. Generally speaking, the higher the monthly premium, the higher the yearly maximum. When patients reach the yearly maximum, they must pay for 100% of any remaining dental procedures. Insurance companies may offer policies that roll over a portion of the unused annual maximum to the following year. How Dental Insurance Pays for Procedures Dental procedures covered by insurance policies are typically grouped into three categories of coverage: preventive, basic, and major. Every policy differs in terms of which procedures are categorized as preventative, basic, and major and whether each is covered. So, it is essential to understand what is covered when comparing policies. Preventive Dental Services Most dental plans cover 100% of preventive care, such as annual or semiannual office visits for cleaning, X-rays, and sealants. These are the most common procedures covered, often without any waiting period. You are typically limited to 2-3 cleaning and routine exam visits per year. Basic Dental Services Basic procedures are treatments for gum disease, extractions, fillings, and root canals, with deductibles, copays, and coinsurance determining the patient’s out-of-pocket expenses. Most policies cover 80% of these procedures, with patients paying the remainder. Most dental insurance policies have waiting periods ranging from six to 12 months before any work can be done. Major Dental Services … Read more