Medical Insurance for Dental Work
How to get Medical Insurance to Pay for Dental Treatment
Getting medical insurance to pay for dental treatment can be tricky but not impossible. The two best ways that medical insurance will pay for dental treatment are:
- A congenital problem: This is something that you were born with that needs to be fixed. Perhaps you were born without a tooth or you have some type of skeletal deformity where you have had difficulty chewing all your life.
- Trauma: If you fell off your bike and broke your teeth or got in a car accident and lost or damaged some teeth/gums, medical insurance might cover this.
- Medical Necessity: if you have a true medical need to have dental work completed, sometimes medical insurance will help to pay for this
Although it can be possible to have your medical insurance help pay for your dental treatment, both you and your dentist must jump through many hoops to make this happen. Often times to get a claim paid by your medical insurance, both you and your dentist must complete extra paperwork, x-rays, photographs, etc. This can add extra time and costs to your treatment but could pay off in the end if your medical insurance will foot the bill.
Be sure to let your dental provider know that you have medical insurance and you hope to use it to be reimbursed for your dental treatment. Give the front office staff your medical insurance card with all necessary personal information to allow them to submit to your insurance.
Medical Insurance for Dental Implants
Dental implants can be a covered benefit for medical insurance in certain situations.
- Are you having trouble chewing?
- Do you suffer from severe periodontal disease (gum disease) and must have all of you teeth removed?
- Did you have a recent accident where you lost one or more teeth?
- Do you have epilepsy and can't have something removable in your mouth and must have a fixed dental restoration?
In some of these situations, medical insurance could cover your dental implant due to a medical necessity. By working with a dentist knowledgeable in medical insurance and medical billing, often times medical insurance will cover some or all of your dental implant treatment.
Is there a good chance that medical insurance will cover my dental treatment?
Using medical insurance to cover dental treatment is possible but never guaranteed. Our doctors and office staff will do everything possible to get your medical insurance to cover your dental treatment, however, there are times when the insurance will still decline the treatment. We like to be up-front with our patients and let them know that nothing is guaranteed with medical insurance and you will be required to pay the fee at the time of treatment and if your insurance does pay for it, we will directly reimburse you. Reimbursement can take anywhere from 60 days up to one year as medical insurance for dental work is a time consuming process.
What about my deductible?
This is where things get tricky. Just like when you are using your medical insurance for medical benefits, you have to hit your deductible before you insurance benefits will kick in. This is why traumatic accidents are a good time to try to use your medical insurance to pay for dental treatment because you have probably already hit your deductible during your hospital or Emergency Room visit. Therefore, you will be able to utilize your insurance benefits better for your dental treatment.