If you are one of the millions of Americans with a dental insurance plan, you likely know some of the benefits that are included. With most plans, you can see your dentist every six months for cleanings and checkups as well as routine X-rays. However, what if you find yourself with a dental emergency that needs immediate attention? Will your dental insurance help you pay for your treatment? Here’s what you should know.
Will Emergency Care Be Covered?
The short answer is partially. The percentage of your treatment that is covered by insurance will depend on the emergency that you have and the treatment that you require. It’s almost impossible to know exactly how much you will be expected to pay out of pocket and how much is covered by your insurance plan until you visit the dental office to have the issue identified.
What Does Dental Insurance Cover?
Every dental plan is different, so you will need to seek this information from your insurance provider to be certain. Here is what the typical structure of a dental insurance plan looks like:
- 100% of preventive care: This includes checkups, cleanings, and routine X-rays. Many dental insurance plans also fully cover at least one emergency exam per year.
- 80% of basic procedures: These services include fillings and direct bonding.
- 50% of major procedures: This consists of more complex services, like dental implants, dentures, and orthodontic treatment.
Every plan has a cap on how much it will cover every year. This is known as your annual maximum. After you reach this, you will be fully responsible for any remaining expenses.
How Does Dental Insurance Affect Cost of Treatment?
Patients with dental insurance will usually have their initial visit covered by their plan. However, the treatment you receive to resolve your emergency will incur a different cost. Your coverage will depend on whether you receive a basic or major procedure, or a combination of the two, so the price can vary quite a bit. Just remember that the longer you put off a dental issue, the worse it will get and the more it is likely to cost. By seeking treatment now, you can save money in the long run.
If you’re worried about the cost of your treatment, reach out to your dental team. Options may be available to help you get the care you need without breaking the bank!
About the Author
Dr. Admasu Gizachew earned his dental doctorate from New York University. Every year, he completes nearly 300 hours of continuing education to stay updated on the constantly developing and expanding field of dentistry. Currently, he is a proud member of the American Dental Association, Academy of General Dentistry, New Jersey Dental Association, and several other professional organizations. For more information or to schedule an appointment at his office in Eatontown, visit his website or call (732) 863-3899.