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Does Dental Insurance Cover Emergency Visits?

December 9, 2021

Filed under: Uncategorized — myomega @ 2:14 am
Woman with toothache

A large percentage of Americans have dental benefits through work or a private plan. However, not everyone completely understands how their insurance plays a role. You know that you can go to your dentist for your regular cleanings and checkups without a problem, but what if you need to head in for an unexpected visit? Will your dental insurance pay for emergency treatment? Continue reading so you can know what to expect.

Will My Emergency Treatment Be Covered?

The short answer is yes – partially. However, the percentage of your treatment that is covered will depend on the type of emergency that you have and the treatment that you require in order to restore your oral health. That’s why it is near impossible to know exactly how much you will be expected to pay out of pocket and how much will be covered by insurance until after you see your dentist and have the issue identified.

What Does Dental Insurance Cover?

Every dental plan is different, so you will need to seek this information from your provider in order to be certain. Here is the typical structure of dental coverage:

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

Every plan has a cap on how much it will cover each year. This is known as your annual maximum. After you reach this, you are fully responsible for all expenses.

How Does This Look in Real Life?

Because your coverage depends on the type of treatment you require, the cost of your visit can vary significantly. For instance, if your emergency is due to tooth decay and you need to have a filling, approximately 80% of your treatment is likely to be covered by your plan. If you need a more complex procedure, you may be left responsible for half of the cost. Just keep in mind that the longer you put off a dental issue, the worse it will get. By seeing your dentist for treatment now, you are more likely to save money going forward.

If you’re worry about the cost of your dental treatment, talk to your friendly dental team. Other options may be available to help. Getting much needed dental care shouldn’t mean stressing over finances!

About the Practice

At Omega Dental in Bedford, you have two experienced dentist, Dr. Prashantkumar Gajera and Dr. Julyat Gajera, who have been working in the field for over a decade. They are both proud members of the American Dental Association and Texas Dental Association. Their practice is in-network with numerous dental insurance providers, and they also welcome out-of-network providers. To learn more about how dental insurance works or to schedule an appointment, visit their website or call (817) 785-3290.

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