Dental emergencies can strike at any time, and when they do how you’ll pay for your care shouldn’t be your main concern. Thankfully, if you have dental insurance, your plan may cover at least a portion of your emergency treatment. Here’s a general guide to estimating how much your policy will cover in the instance of a dental emergency.
What Does Dental Insurance Cover?
Unlike medical insurance, dental insurance places more of an emphasis on preventive care (as opposed to emergency care). Because of this, many plans cover routine care like exams, cleanings, and x-rays at 100 percent or nearly 100 percent. For emergency procedures such as tooth extractions and root canals, your plan may not fully cover your treatment. Instead, most plans cover around 80 percent. Finally, for procedures that are considered “major,” such as dentures or dental bridges, many plans provide about 50 percent coverage. Be aware, however, that many plans have specific limits on how much they’ll cover for an emergency treatment, so be sure to ask your dental team or provider if you have any questions about your specific plan.
Other Factors that Affect Emergency Coverage
There are several other factors that could influence whether or not your dental insurance will cover emergency treatment. These include:
- Your specific insurance plan: Because each plan is different, not all policies will cover the same amounts, treatments, or even the same providers, so check with your plan administrator or the billing team at your dentist’s office.
- The type of care needed: Some plans may cover certain types of emergency treatments more completely than others, while some may not include certain plans at all.
- Network restrictions: If your dentist is not in-network, this could affect the cost of your treatment.
- Pre-existing conditions: If you have a dental emergency that is related to a pre-existing condition your dental insurance may cover less, so be sure to review your plan’s exclusions to familiarize yourself with this.
Remember, the midst of a dental emergency isn’t usually the best time to wonder how much care your dental insurance policy will cover. To eliminate confusion and get a better understanding of your plan, speak to your insurance administrator, call your provider, or reach out to your dental team with any questions or concerns. While costs may vary, the peace of mind you’ll have when you understand your coverage is priceless!
About Dr. Daaboul
Dr. Jason Daaboul earned his undergraduate degree at Texas A&M University and his dental degree at the University of Texas Health Science Center at San Antonio Dental School. A big proponent of continuing education, he has taken countless hours of studies with prestigious organizations such as the Spear Institute. Dr. Daaboul is an active member of the American Dental Association, Texas Dental Association, Fort Worth District Dental Society, and the American Academy of Clear Aligners. If you are suffering from a dental emergency, please call Daaboul Family, Aesthetic & Implant Dentistry as soon as possible at 817-646-7306.