When Are Dental Procedures Covered by Medical Insurance? There is no doubt that dental health plays a paramount role in overall health. The importance of oral and dental care cannot be underscored, as evidence has shown that periodontal disease can negatively impact your overall health—even if you don’t experience symptoms. This is why so many people wonder about whether dental cleanings and other common procedures are covered by medical insurance.
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Dental Procedures That Are Usually Covered
Most dental procedures are not covered by medical insurance. This is because dental insurance is considered a separate type of insurance. There are a few dental procedures that are usually covered by medical insurance, however. These procedures are generally considered to be medically necessary.
Dental Check-ups
Most dental insurance plans cover one or two routine dental check-ups each year. A routine dental check-up includes an exam by the dentist and a cleaning by the hygienist. Some dental insurance plans also cover preventive services such as fluoride treatments and sealants.
Dental X-Rays
Dental X-rays are a type of radiograph that dentists use to examine a patient’s teeth and jaws. Dental X-rays can help reveal unseen problems, such as decay or damage, that cannot be detected during a physical examination.
Dental X-rays are usually covered by medical insurance, but the coverage may vary depending on the individual policy. Some insurance plans may only cover certain types of X-rays, while others may only cover X-rays that are deemed medically necessary.
Dental X-rays are an important tool that dentists use to diagnose and treat oral health problems. If you have dental insurance, check with your insurer to see what coverage they provide for dental X-rays.
Dental Cleanings
Dental cleanings are usually covered by insurance and are an important part of prevention and maintenance. They should be done at least once a year, and more often if you have gum disease or other risk factors. During a cleaning, your dentist or hygienist will remove plaque and tartar from your teeth and gums. They will also polish your teeth and provide you with oral hygiene instructions.
Dental Procedures That Are Sometimes Covered
Although most dental procedures are not covered by medical insurance, there are a few that are considered medically necessary and are therefore covered. These procedures include extractions, dental implants, and dentures. If you are considering any of these procedures, be sure to check with your insurance provider to see if they are covered.
Dental Fillings
Most insurance companies cover the cost of dental fillings, which means that you will only have to pay a small percentage of the total cost out-of-pocket. Insurance companies typically cover the following types of dental fillings:
- Composite (tooth-colored) fillings
- Amalgam (silver) fillings
- Gold fillings
Insurance companies will sometimes cover the cost of replacement dental fillings if they are necessary due to decay or damage. However, they will not cover the cost of cosmetic dental procedures, such as teeth whitening.
Dental Crowns
crown, also called a cap, is a dental restoration that completely covers a tooth. It’s used to restore the function and appearance of the tooth. A dental crown may be needed when:
- A tooth is so damaged that it needs to be restored with a filling but there isn’t enough tooth remaining to support the filling.
- A tooth is so badly damaged that it needs to be extracted. In this case, a dental implants or bridge may be placed over the extracted tooth.
- A tooth has had a root canal and needs to be protected from fracture.
- A dental implant needs to be covered.
Dental Bridges
Dental bridges literally bridge the gap created by one or more missing teeth. A fixed dental bridge is cemented to the natural teeth or implants surrounding the empty space. This type of dental bridge cannot be taken out of your mouth as you might do with removable partial dentures.
Bridges are an excellent way to replace missing teeth not only for cosmetic reasons, but also to prevent other teeth from shifting out of position, which can lead to a bad bite.
Your dentist will take X-rays and make models or impressions of your teeth, which will serve as a template for your custom-made dental bridge. The pontic, or artificial tooth, is then attached to crowns that go over each of the adjacent anchoring teeth. These adjacent teeth serve as abutments and are prepared by removing some of the enamel to allow room for a crown to be placed over them. Once these supporting crowns are cemented in place, the pontic is attached to them and your dental bridge is complete!
Dental Procedures That Are Rarely Covered
There are many dental procedures that are not covered by medical insurance. This includes cosmetic procedures, braces, and whitening. However, there are some dental procedures that are considered medically necessary and are covered by insurance. These include fillings, crowns, and extractions.
Dental Implants
Dental implants are a common dental procedure that is usually covered by dental insurance. However, there are some cases where dental implants are not covered by insurance. In these cases, the patient may have to pay for the procedure out of pocket.
Dental Veneers
Dental veneers are often thought of as a cosmetic procedure, but they can actually be used to protect the surface of your teeth from damage. Veneers are thin, custom-made shells that are bonded to the front of your teeth. They can be made from porcelain or composite resin, and they are typically used to improve the appearance of your smile. However, veneers can also be used to protect your teeth from chips, cracks, and other types of damage.
Veneers are not typically covered by dental insurance, so they can be a costly procedure. However, they are usually considered to be a long-term investment because they can last for many years with proper care. If you are considering dental veneers, be sure to discuss all of your options with your dentist to determine if they are right for you.
Teeth Whitening
While many dental procedures are covered by medical insurance, there are some that are rarely covered. One of these is teeth whitening. While some insurance plans may cover a portion of the cost of teeth whitening, it is typically not covered in full. This is because teeth whitening is considered to be a cosmetic procedure, and most insurance plans do not cover cosmetic procedures. If you are considering teeth whitening, you will likely have to pay for it yourself.
