Dental Insurance 101: Are Emergencies Covered?

May 6, 2024

Filed under: Uncategorized — Erika Philips @ 6:39 pm
Closeup of a dental benefits claim form with pen and glasses

No matter how prepared you are, you can never fully predict when a dental emergency might strike. Whether it’s a sudden, severe toothache or a knocked-out tooth or filling, these urgent situations can occur at any time.

It’s crucial to seek immediate help to maintain your oral health during a dental crisis. However, the last thing you want to worry about when you’re already in pain and/or anxious is how to manage the cost of your dentist’s services. Fortunately, if you have insurance, it can provide a much-needed financial safety net. Read on to discover how dental policies can offer relief in an emergency!

How Much Does Emergency Dental Care Cost?

If you’re having a problem that needs immediate attention, it’s natural to feel anxious about the cost. Unfortunately, it’s not always possible for your dentist to provide an estimate in advance because they won’t know what’s needed until they complete an oral examination.

Some factors that contribute to the total amount due can include:

  • The severity of your issue, infection, or injury.
  • The type of treatment required to resolve it.
  • The cost of living where you’re seeking urgent care.
  • Your specific dental insurance plan.

Does Dental Insurance Cover Emergencies?

Typically, most insurance policies include certain provisions for emergency scenarios and after-hours services. That said, there are often restrictions that you must adhere to first. For example, you’ll have to meet your deductible before coverage kicks in. You’ll also likely have a co-pay and can expect to cover a portion of the final payment yourself.

Some common services many providers include are:

  • Preventative care. Often, 100% of the cost of routine checkups and dental X-rays are covered.
  • Basic procedures. Many plans contribute to 80% of treatments like dental fillings, root canals, and simple extractions.
  • Major procedures. More complex solutions like dental crowns, bridges, and dentures are frequently covered at 50%.

Every plan is different, so it’s important to check the details of your policy to know what’s included.

How Can I Make Emergency Dentistry More Affordable?

If you do find yourself in an urgent situation and are uninsured, don’t panic! Many dentists understand that not everyone has access to an insurance policy and are willing to work with you to ensure that you can help when you need it most. You can ask your provider whether they offer other options, like third-party financing through CareCredit. Also, many practices offer their own in-house membership plans for a flat fee that includes discounts on various services.

Thankfully, your budget doesn’t have to hold you back from getting essential services when you’re in the middle of a dental emergency!

About the Author

Dr. Robert Nicholas Slezak enjoys helping people of all ages build and maintain the best version of their smile. He attended the University of California in San Diego for his undergraduate degree and then pursued his dental doctorate at Case Western Reserve University. Now, he offers a full array of services under one roof to meet all of your and your family’s dental needs, including emergency services. He combines a relaxed, friendly approach with state-of-the-art technology to verify the extent of the problem and provide fully individualized solutions. Plus, if you’re overly anxious or in pain, he offers nitrous oxide so that you don’t have to wait for relief. If you have an issue that needs immediate attention, you can contact the office on the website or by calling (440) 285-8211.