Dental Insurance Plans: Things Covered and Not Covered

What Exactly is Dental Insurance?

As is evident in its name, a dental insurance policy aims at covering all related costs to dental health. This means that any cost incurred on the treatment of teeth, including dental implants, surgeries, root canal treatments, teeth whitening, straightening, and the like, can be covered under dental insurance plans.

There are two types of dental insurance policies:

1. Stand Alone Dental Insurance
2. Dental Insurance Cover provided as part of a health insurance policy

Now, as the name suggests, a stand alone dental insurance refers to a plan that is purchased exclusive of a health insurance policy or mediclaim. This is generally done in case dental coverage is not already included under your healthcare plan and you’d like to have dental care covered separately.

Some healthcare plans provide dental insurance coverage as part of the base policy. This is called a dental insurance cover. In this case, a stand alone dental insurance policy need not be purchased separately since it is already a part of the base health insurance plan that you have already bought from your insurer.

Coverage Provided Under Dental Insurance Plans

Now that we understand what dental insurance is generally used for, let us look at what all it covers.

A dental insurance policy works just like any other healthcare plan, offering different cost coverages as per the discretion of the said insurance company that has issued the policy. This means that the treatments covered under different dental insurance plans may vary from one plan and one insurer to another. However, for the purpose of understanding, here we list out some of the most common areas covered under dental insurance plans:

• Cost incurred on dental implants and surgeries
• Extraction of decayed tooth
• Treatment of gum disease or Periodontitis
• Cost of X-rays taken for tooth analysis
• Accidental injury to the tooth/teeth
• Filling of cavity
• Root canal treatments
• Routine oral visits
• Follow-up visits to the dentist for treatment of an oral condition and post-treatment maintenance

If you are required to take any of the above treatments or undergo any procedure for dental care, make sure to avail the dental health insurance policy for cost coverage of the same.

Exclusions Under Dental Insurance Plans

Just like a normal health insurance policy, dental insurance too covers some aspects of dental care costs and leaves out some of the others. In order to buy dental insurance for yourself and/or your loved ones, it is essential to know what is not covered under the plan so that you can make a more informed choice regarding maintaining your teeth:

• Treatment performed to align jaw displacement or correction
• Any dental procedure performed with relation to a pre-existing health condition that was not performed to the insurer at the time of policy purchase
• Any cosmetic procedure performed for dental correction
• Placement of dentures
• Treatment done for fitting of braces or Orthodontic treatments

Any procedure performed from above is liable for dental cover exclusion. However, as stated earlier, dental cost coverage varies from one plan to another and also from one insurer to the other. This means that each insurer has the right to include or reject a particular coverage area in dental health insurance plans.

Thus, it is always essential to check with your individual insurer or insurance company about what is covered or not covered as part of dental health insurance plans.

Tips to Choose the Right Dental Insurance

In case your general health insurance cover fails to provide a dental insurance cover, you can purchase one from your insurer. In that case, it would help to bear the following points in mind:

1. Each health insurance policy has different guidelines for different dental insurance covers. Hence, it is very important to read each policy and the details written in it closely before signing it up.
2. A detailed comparison between the advantages offered by different dental health insurance plans as well as their pricing is important
3. Ideally, try and go for a health insurance plan that covers dental insurance as a part of it. In case you’re unable to find one, only then look for stand alone dental covers.
4. Always look over the section detailing network hospitals associated with the said hospital. It helps to know the nearest hospital available in case of an emergency.
5. If your dental insurance plan covers costs for dental implants and surgeries, it would always be helpful since accidental injury or other similar reasons causing harm to the tooth may happen. The cost for the treatment of dental implants is generally very high and therefore a healthcare plan that covers dental insurance costs is needed.