What Dental Procedures Are Covered by Medical Insurance?

January 20, 2024

Health and dental insurance are not one in the same. While there are some medical plans that include health and dental coverage, many people have to purchase separate health and dental insurance policies. Each policy has its own deductible and premium. Like health insurance, the types of procedures your dental insurance covers can vary by policy and provider.

This Live Health guide to dental insurance will explain what you can likely expect to see covered under your own policy.

Medical Insurance vs. Dental Insurance

Comprehensive medical insurance is designed to cover preventive care and treatment for a wide range of health conditions, as well as certain treatments for mental health problems.

Some medical insurance plans can include dental policies. In other cases, medical insurance does not pay for dental procedures, such as cavity fillings, extractions, cleanings, and orthodontic treatment unless they are deemed medically necessary, such as surgery for a jaw problem.

For general oral hygiene and comprehensive dental care, most people purchase separate dental insurance policies. These offer dedicated coverage for your dental needs, including routine and emergency care.

Types of Procedures Covered by Dental Insurance

Live Health offers dental insurance policies that cover a wide range of services to help you protect your oral health and general well-being. By purchasing a policy, you can expect to receive coverage for various dental procedures, including the following:

Dental Exam

Patients are advised to have at least two annual dental exams and cleanings each year. Insurance policies may cover one or both of these at no extra charge. During the exam, your dentist will take X-rays or digital 3D scans of your face, examine your teeth, gums, and tongue, and screen for oral cancer, cavities, gum disease, and other oral health problems.

Dental Cleanings

Typically combined with an exam visit, cleanings are important for removing plaque and tartar from your teeth to prevent the development of cavities and gum disease. Routine cleanings are the most important type of preventive dental treatments.

Fillings

Fillings include removing infection and tooth decay from a tooth and filling the space with a special material like amalgam (a mixture of metals), composite (a mixture of plastic and resin), ceramic, or gold. Fillings are the best way to treat cavities and prevent future tooth decay.

Root Canal Therapy

A root canal is a dental procedure that removes infection from the tooth’s most internal layer — the pulp.It is performed by a dental specialist called an endodontist. During the treatment, infection is thoroughly removed from the tooth and the canals of the root are cleaned. The space is then sealed and topped with a cover called a dental crown. If your dentist tells you that you need a root canal, it is important to get treatment ASAP since this will protect your tooth from severe infection or even complete loss of the tooth.

Dental Crowns

Crowns are covers made from metal or porcelain that cover a damaged tooth to prevent future cavities and decay. Dental insurance only covers crowns when they are deemed medically necessary, not for cosmetic purposes. A dental crown is often recommended for patients who repeatedly have problems with their tooth or who have severe infection in a tooth.

Extractions

In some cases, it is best to have an injured, damaged, or infected tooth removed to protect the other teeth and your gums. When a dentist removes a tooth, it is called an extraction.

Extractions can be covered by dental insurance as they are generally only performed when medically necessary.

Dental Implants

A dentist can replace a patient’s missing teeth with a device called a dental implant. A titanium screw replaces the natural root of the tooth, and it is covered by a natural-looking crown that blends into your smile. At the same time, dental implants improve your ability to speak and chew, and they can prevent bone loss from missing teeth.

Dental implants are covered when they are medically necessary and not just for cosmetic purposes.

Dental Bridges

A bridge is a tooth replacement treatment that uses an artificial tooth called a pontic. The pontic is attached to dental crowns on either side, forming a bridge in the middle that covers a gap from a missing tooth.

Gum Disease Treatment

Also called periodontal therapy, treatment for gum disease includes care for both gingivitis and the more severe version, periodontitis. This type of treatment can include a deep cleaning called root scaling and planing, and gum surgery.

Orthodontic Treatment

Some patients need to see a jaw specialist called an orthodontist. These are the dentists who apply braces, Invisalign, and offer teeth-straightening treatments. When treatment is considered necessary to improve jaw function and oral health, it may be partially or fully covered by dental insurance. It is not covered when it is cosmetic.

Oral Appliance Therapy for Sleep Apnea

Patients who have obstructive sleep apnea (OSA) may benefit from a custom mouthguard that keeps their airway open as they sleep. Dental insurance may cover this treatment.

Get the Best Dental Coverage for Your Need

Visit our dental insurance page to learn more about how to get the right policy. You can also contact us to learn more. Our knowledgeable dental insurance brokers are always here to help.

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