Many patients want to know if dental insurance covers sedation dentistry. Unfortunately, there’s no easy answer for that. It depends on your insurance provider and the dental procedure you need done. Here are some of the cases when sedation dentistry is often covered by dental insurance.
Dental insurance will often cover sedation dentistry for procedures that just wouldn’t be possible without it. Tooth extraction is one such procedure. Local anesthesia is often not enough for such a potentially painful or drawn out dental procedure. Inversely, insurance will often cover smaller, less expensive treatments that require lighter anesthesia like laughing gas.
Some dental procedures, like wisdom teeth removal and root planning, are completed in four steps on four separate dentist visits. That’s no fun for you, or for your insurance company, believe it or not. They would rather pony up for your dental sedation and have all four procedures done at the same time versus paying for you to go into the dentist without sedation four separate times. In this case, your insurance provider wants you to get your trip to the dentist over just as quickly as you do.
If a child on your health insurance plan is under a certain age mandated by your provider, they’re often eligible for sedation dentistry benefits. It’s understood that many young children don’t handle visits to the dentists well, so this option is often included in family insurance plans.
If you represent an adult with special needs or a disability, dental insurance plans will often offer sedation dentistry for the disabled individual. Certain conditions, like epilepsy, are also a cause for your insurance provider to pick up this tab.
Remember, even if your insurance plan covers sedation dentistry, your policy’s annual maximum may not cover the full treatment, which means you could still owe money out of pocket. Read your insurance policy carefully beforehand so you don’t get bit by unforeseen fees after the fact. Call your provider’s customer service number to discuss your policy questions before going ahead with treatment plans.
Even if your insurance policy doesn’t cover sedation dentistry, weigh your options. For some, this treatment is an absolute necessity. It can take away any pain and fear you feel about your dentists visit and put your mind at ease. If you’re worried about footing the bill, many dentists offer very fair and affordable financing plans, or can steer you to a third party provider that they recommend for patients. However, be very careful with third party credit cards. Read the fine print as some of them have very high interest rates that start accumulating the moment you are approved, not 30 days after the procedure is performed.
If you feel like you can’t do without sedation dentistry, it’s always possible to work something out. You should not have to grin and bear it if you don’t want to!
Adam H. is a freelance journalist. This article was written for Las Vegas Sedation Dentist Dr. Steven Delisle.