Does Health Insurance Cover Dental Work?

October 10, 2022

If you have health insurance but have a dental issue, you might wonder if your health insurance covers dental work.

The answer is that it depends.

Health insurance typically doesn’t cover dental work, especially routine or preventative dental work. However, there are a few situations where your health insurance might cover dental issues.

When Does Medical Insurance Cover Dental Issues?

The only time medical insurance will cover dental issues is when you have a major trauma, injury, or illness that also affects your dental health. The reason for the dental appointment must be medically necessary, and the cause must be a covered medical condition.

For example, diabetes and osteoporosis can cause dental health issues. Since both illnesses are covered by medical insurance, you may be able to get dental health issues that occur because of them being covered.

You may also get dental work covered under medical insurance if you experience trauma or a major accident. For example, if you were in a major car accident that caused physical and dental injuries, you might get dental health issues approved by your medical insurance.

What is Dental Insurance?

Dental insurance is a policy separate from your major medical insurance, although some insurance companies offer dental insurance as an add-on to your medical coverage. You can get dental health plans through your employer (if they offer them) or as a stand-alone policy.

Dental insurance plans aren’t hard to get; you don’t have to qualify for them, and the premiums are much less than traditional medical insurance.

Be careful, though, as you shop for dental insurance that you aren’t getting a dental discount plan versus insurance. While they have the same outcome, they work differently.

Dental Insurance vs. Dental Discounts

Dental insurance works a lot like medical insurance. You pay a monthly premium and have a deductible. In addition, the policy typically includes two free cleanings per year, and you pay coinsurance on any other procedures.

The dentist bills the insurance company directly, and then your insurance company tells you how much you owe for coinsurance versus how much they’ll pay.

On the other hand, dental discount plans have one annual fee, and you get a membership card. The card entitles you to lower contracted rates with certain dentists. Unlike insurance, the dental office bills you directly. Typically you have to pay in full at the time of service, but the amount you pay is discounted from their regular rates.

You don’t have a deductible or a limit to the number of visits per year, as you are responsible for the bills yourself.

Final Thoughts

Having dental insurance is just as important as medical insurance. Your mouth is the gateway to your overall health. Regular checkups and early treatment are essential to your overall health. While your medical insurance likely doesn’t cover your dental health, you can get a separate dental insurance policy to protect your oral health and stay in good health.