Will My Dental Insurance Cover Emergency Treatment?

woman with bad toothache

Many Americans have dental benefits through their employer or other means. However, they might not fully understand how their benefits can help them. Of course, you can go to the dentist for regular cleanings and checkups without a problem, but what if you encounter an unexpected predicament? How much will you owe to get urgent treatment from your emergency dentist in Sebastian? Read on to learn more about dental insurance.

What Types of Dental Insurance Plans Are Available?

Here are the most common options when it comes to dental insurance:

  • Preferred Provider Organization (PPO): This plan allows you to select from a list of dentists that accept the plan or choose your own dental provider. If you go to a dentist that is out of network, your out-of-pocket costs will typically cost more.
  • Dental Health Maintenance Organization (DHMO): These plans provide a network of dentists that accept the plan for a set co-pay or no fee at all. However, you must choose one of these dentists and will not receive coverage for those that are not in-network.
  • Discount Dental Plan: Here you get a discount on dental services from a select group of dentists, but the plan doesn’t cover your care. Instead, the participating dentist will give you a discount on your treatment.

What Do My Benefits Cover?

Each dental plan is different, so you will need to seek this information from your insurance company to be certain. Here is the typical structure of coverage:

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

Each plan will have a cap on how much it will cover per year, known as your annual maximum. After you reach this threshold, you are fully responsible for all expenses.

Are My Emergency Dental Treatments Going to Be Covered?

This completely depends on the type of emergency you have and the treatment you require to restore your oral health. For example, if your emergency is due to a cavity and you need a filling, 80 percent of the treatment will likely be covered by your plan. If you need a more complex procedure, you may be left responsible for half of the costs. You should keep in mind that the longer you put off a dental issue, the worse it will get. If you have the issue addressed now, you are much more likely to save money in the big picture.

If you’re worried about the expenses of dental treatment, it’s worth talking to your dental team. They may be able to help with other financial options. Receiving essential dental care shouldn’t mean breaking the bank!

About the Practice

At Sebastian Dental, we pride ourselves on being the friendliest dental team you’ll find. It’s a priority to make you feel welcome, and if the unexpected ever happens, we want you to count on us as your emergency dentist. Plus, our team is here to help you maximize your dental insurance. When you need assistance with any oral health issue, we’ll be ready. You can schedule an appointment on our website or by calling (772) 388-0088.

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