Taking care of yourself is essential if you want to live a healthy life. For those without dental insurance, you may be wondering if you can use medical insurance to cover dental work. Since dental care is an important part of maintaining your overall health, the answer is maybe.
This will largely depend on your medical insurance provider, dental office, and the dental work that’s needed.
Dental Work and Medical Insurance
If you’re wondering what dental procedures are covered by medical insurance, this can vary from provider to provider. Talk to your insurance company to find out if and what procedures may be covered. There are certain times when dental work can be classified as medically necessary, which medical insurance may cover.
In addition to speaking with your medical insurance provider, be sure to speak with your dental office as well. The dental office may require payment up front for treatment costs and ask the patient to submit a claim to their medical insurance for reimbursement.
Diagnostic Procedures
The purpose of medical insurance is to cover exams and tests that look for medical issues. If it’s believed that the issue stems from problems in your mouth, the diagnostic procedures could be covered by your medical insurance—even if you’re having the tests done in a dental office.
Some of the things that could be covered include exams, bacterial testing, emergency x-rays, and medical imaging. Medical issues can cause dental issues, and vice versa, so finding out what’s wrong to create a treatment plan may require medical insurance paying for dental diagnostic procedures.
Non-Surgical and Surgical Medical Treatments
If a medical condition is found and can be treated with dental work, it’s possible your medical insurance will help cover the cost of the treatment. In some cases, part of treatment may require dental surgery.
This typically occurs if a medical provider diagnoses a medical condition and refers the patient out to a dental practice. Since the treatment is considered medically necessary, your medical insurance is likely to cover some or all of the cost.
Traumatic Injuries
If you get into an accident of any kind and it causes damage to your mouth or teeth, this could be covered by medical insurance. However, before filing the claim, check to see if your injury is covered by any other insurances.
For example, a traumatic injury resulting from a car crash, could be covered by auto insurance or an accident on someone else’s property could be covered by homeowner’s insurance or liability insurance.
Traumatic Treatments Covered by Medical Insurance
When medical insurance kicks in to cover traumatic injury treatments, any procedure that is necessary to restore the original look and function of the mouth should be covered. This might include the following:
- Prosthodontics
- Surgery
- Dental Implants
- Endodontic treatments
- Restorative care
Depending on your provider, medical insurance may step in to cover all or part of treatments and procedures necessary to fix the issue.
Dental Insurance
Most dental procedures will not be covered by medical insurance. You can check with your dental office to see which dental insurance providers they participate with and choose a dental insurance plan that best meets your needs.
Here at Cornerstone Dental, we are selective for which dental insurances we in-network with, however, we submit claims and work with almost all insurances to help you obtain maximum benefits
Why Cornerstone Dental Isn’t In-Network
Dental insurance companies stay in business only if more money is collected in premiums than is paid out benefits. Knowing this, the dental insurance company must maintain an illusion that the opposite is happening.
An examination of most dental insurance policies may reveal restricted access to providers, premium and deductible costs exceeding the usual fees, limitations on the services and procedures covered, and a limit to the maximum benefit that the insurer will pay.
We believe that by keeping fees in the ‘usual and customary’ range, Cornerstone Dental’s non-insured patients typically pay less overall. For our non-insurance patients, we offer interest-free financing through CareCredit as well as payment plans and Cornerstone Club.
Regardless of your insurance coverage (or lack of it) we are pleased to provide an estimate of your payment responsibly and that of your insurer.
Are You Searching For A Martinsburg Area Dentist For You Or Your Family?
If you’re searching for an experienced dentist please feel free to contact us online or call our Martinsburg, West Virginia dental office directly at 304.267.6059 to schedule your appointment. We provide a wide range of general dentistry care as well as more involved dentistry services for patients throughout the Martinsburg area and look forward to you joining the Cornerstone Dental family.
