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Does Your Dental Insurance Cover an Emergency Visit?

November 4, 2021

Filed under: Uncategorized — salmonbrooke @ 2:23 am
man with bad toothache

It’s helpful to have dental benefits through your employer or by other means, but fully understanding how those benefits can help you is essential. Of course, you can go to the dentist for regular cleanings and checkups without a problem, but what if you encounter an unexpected predicament? How much will you owe to get urgent treatment from your emergency dentist in Granby? Read on to learn more about dental insurance.

What Are the Differences in Dental Insurance Plans?

Here are the most common options when it comes to dental insurance:

  • Preferred Provider Organization (PPO): This allows you to select from a list of dentists that accept the plan or choose your own dental provider. If you go to a dentist that is out of network, your out-of-pocket costs will typically cost more.
  • Dental Health Maintenance Organization (DHMO): These plans provide a network of dentists that accept the plan for a set co-pay or no fee at all. However, you must choose one of these dentists and will not receive coverage for those that are not in-network.
  • Discount Dental Plan: Here you get a discount on dental services from a select group of dentists, but the plan doesn’t cover your care. Instead, the participating dentist will give you a discount on your treatment.

What Treatments Will My Benefits Cover?

Each dental plan is different, so you will need to seek this information from your insurance company to be certain. Here is the typical structure of coverage:

  • 100% of preventive care: This includes checkups, cleanings, and routine X-rays.
  • 80% of basic procedures: Basic services include fillings and periodontal scaling.
  • 50% of major procedures: This includes more complex services like dental implants, dentures, and orthodontic treatment.

Each plan will have a cap on how much it will cover per year, known as your annual maximum. After you reach this threshold, you are fully responsible for all expenses.

Is My Trip to the Emergency Dentist Going to Be Covered?

This completely depends on the type of emergency you have and the treatment you require to restore your oral health. For example, if your emergency is due to a cavity and you need a filling, 80 percent of the treatment will likely be covered by your plan.

If you need a more complex procedure, you may be left responsible for half of the costs. You should keep in mind that the longer you put off a dental issue, the worse it will get. If you have the issue addressed now, you are much more likely to save money in the big picture.

If you’re worried about the expenses of dental treatment, it’s worth talking to your dental team. They may be able to help with other financial options. Receiving essential dental care shouldn’t mean breaking the bank!

About the Author

Dr. Kenneth Endres has been working for the smiles of his patients for nearly four decades. He earned his dental doctorate from Howard University and went on to serve as a dentist in the Air Force for two years. If you ever need an emergency dentist, Dr. Endres is open several evenings weekly and on Saturdays, plus dental insurance is accepted. You can schedule an appointment on his website, but if it’s an emergency, call (860) 653-4551 and he will try to see you that same day.  

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