In a dental emergency, cost should never keep you from receiving care you need, but you may wonder whether your insurance plan will help cover your costs. What is and is not covered in a dental emergency? What will you have to pay for out-of-pocket?
With so many variations in specific coverage and policies adjusting each year, it’s impossible to say which services are and aren’t covered for all dental insurance plans in a dental emergency. However, some general principles tend to be the norm and can help you know what you might expect. Just keep in mind that your specific plan may be an exception or differ.
Might Be Covered: Diagnostic X-Rays
Usually, insurance plans allow for one set of extra X-rays per year for an emergency. As a result, you may only have to pay a portion or perhaps even none of the cost of diagnosing the issue. Treatment is probably a different story. Normally, minor and major dental work is covered only partially by insurance, but you won’t have to foot the bill entirely on your own.
Might Be Covered: Root Canal Treatment
A deep crack or cavity in a tooth requires root canal treatment, and, fortunately, most insurance policies pay about half of the cost of this procedure, reducing your out-of-pocket costs.
Might Be Covered: Restorations
If a dental emergency leaves your tooth weaker or non-functional, your dental insurance will pay anywhere between 50 to 70 percent of the cost of a restoration. This means you can get a filling or crown and regain your smile’s function.
Likely Not Covered: Aesthetic Repairs
Although a chipped or lightly cracked tooth may feel urgent and critical to fix, dental insurance companies mostly disagree. Correcting cosmetic chips or cracks is mainly considered elective or optional. As a result, dental insurance plans generally do not cover procedures like veneers, cosmetic bonding, and the like. You will likely have to pay the full amount by yourself.
Likely Not Covered: Dental Implants
For a knocked-out tooth, the best solution may be a dental implant, which is second only to natural teeth. However, you should know that this replacement option has spotty coverage. Insurance will likely not pay toward the cost of the placement surgery, which is the main expense, but the company may help pay for the cost of the restoration (i.e., the crown, bridge, or denture) at the end of treatment.
Ultimately, your dental team can review your plan and help you understand what benefits are available for you if you experience a dental emergency. With them by your side, you can maximize your coverage and save as much as possible.
About the Practice
With three highly trained and experienced dentists on staff, Legacy Trails Dental is proud to serve patients of all ages. We happily accept basically all dental insurance plans and are in-network with most of them. As a result, our patients can save significantly on oral care expenses. For costs outside of insurance, we can help you apply for flexible financing, which divides the total into smaller monthly installments. To learn more about using your dental insurance, contact our Plano office by calling 214-227-1000 or clicking here.