Does Health Insurance Cover Dental Surgery?
If you are suffering from excruciating tooth or gum problems that require dental surgery, you could end up with an expensive bill. Dental procedures, especially dental surgery, can become a painful financial drain without insurance. So it is very important that you explore and understand all of the insurance options available to you and your family.
Most private health insurance plans do cover dental emergencies such as tooth damage due to an accident. However, they do not automatically cover dental surgeries such as root canals and dental procedures such as cleanings, fillings, etc. Consumers can often add them to their plans at an extra cost. Dental insurance riders provide the policyholder with different levels of coverage, depending on their insurance plans.
Dental surgery procedures such as root canals or teeth fillings can easily cost upwards of $1,000 per operation. Given such high costs, getting dental insurance is likely to pay off in the long run. This is especially true if you have a young family.
How Can I Get Dental Coverage?
If you have a private health insurance plan, talk to your insurance provider. Ask them about the different dental coverage options they provide. Much like any health insurance plan, you can tailor your dental insurance plans to meet your specific needs.
You can go the traditional route and get a stand-alone dental insurance plan along with your health insurance plan. Similar to a traditional health insurance plan, you will be responsible for meeting deductibles and co-pays before the insurance company will pay a certain percentage of every dental treatment you undergo.
Signing up for a dental insurance plan will require monthly premium payments. You might also be required to wait for a certain period of time before the plan becomes effective and allows dentist visits.
Another option is to sign up for a dental discount plan. A cheaper option than traditional dental insurance plans, this might be a viable choice for many consumers.
However, these discount plans come with specific limitations. Patients are allowed access to a select, pre-determined number of dental providers for often-used services such as teeth cleanings, cavity repair, and root canals, among others. As the name implies, plan holders get a certain amount of discounts for each procedure.
If you fall under the purview of government-sponsored healthcare such as Medicaid, you need to talk to your insurance provider. The regulations for dental insurance vary from state to state for adult recipients. Most states do provide emergency dental care for all adults and are mandated to extend comprehensive dental coverage for individuals below the age of 21.
What is a Dental Rider?
A rider is defined as a modification to an existing insurance policy that tacks on a new form of coverage or raises the coverage limit. A rider usually implies a higher monthly premium.
A dental rider might be an optimal solution for those consumers who do not want to pay for traditional dental insurance, yet need more than a discount dental plan. Other forms of insurance riders include vision and maternity.
What Does Dental Insurance Cover?
Most dental plans have a network of dental professionals who offer a range of services that are either covered fully or come with a co-pay. Diagnostic and preventive care are often free of cost. Depending on the policy, dental patients will largely be covered for 80% of cleaning and tartar removal procedures, teeth X-rays, and general check-ups. Denture cleaning and repair is also substantially covered.
More complicated procedures such as root canals, oral surgery, cavity filling, and periodontal problems are covered for approximately 50% of the costs, depending on the policy.
Before signing on for any dental plan or policy, make sure you understand the exclusions. Most dental plans will not cover you for teeth whitening, veneers, and other cosmetic dentistry procedures.
Additionally, a major exclusion in most dental insurance plans is orthodontic work. Since getting braces is not considered preventive or basic care, you are likely to be denied any coverage. If you have children who need braces, you might consider getting supplementary orthodontic insurance. Depending on the plan, this could cover you for at least half the cost of braces. With braces costing thousands of dollars, this might be a worthwhile investment.
If you need quick dental care, make sure you are eligible for immediate dentist visits. Some insurance companies could require waiting periods starting at three months and going up to a year before you can get treatment for a serious dental problem.
Does the Affordable Care Act of 2010 Impact Dental Insurance?
The new Act does not directly apply to group dental benefits. The law may require the restriction of lifetime and annual limits placed on coverage by insurance companies. However, under the Affordable Care Act, children are exempt from any exclusion and have the right to preventive procedures and basic dental treatments.
Given the variety of options available, take the time to do some research before signing on the dotted line and you are likely to find an optimal dental insurance plan that will meet all your requirements and your budget.