Most dental insurance policies cover preventative care, such as checkups and cleanings, as well as routine dental work like fillings and extractions. Coverage for other treatments varies by plan, with more expensive policies covering more procedures. Mouth surgery and some treatments may only be partially covered. Regular checkups and cleanings are usually fully paid for and should be done at least once a year. Dental plan coverage often extends to routine care when a problem is discovered during a checkup.
In general, most dental insurance policies only cover treatment that is deemed medically necessary. This often includes preventative dental treatment, such as regular checkups and cleanings. Routine dental work that focuses on keeping your teeth and gums in good shape is also often covered and usually includes fillings, tooth extractions, and crowns. Other types of treatments may only be partially covered, such as root canals, dentures, and braces. Dental plan coverage usually depends on the plan you choose, with the more expensive policies usually covering more procedures.
Even the most basic plan usually covers regular preventative care. For example, checkups are usually covered under the typical plan because most providers realize that preventing dental problems is less expensive for them than treating major problems that develop after a lack of routine care. Therefore, checkups and cleanings are usually fully paid for and should be done at least once a year. Regular checkups often involve maintaining the health of your gums, not just your teeth, as gingivitis and gum recession can be easily cured if caught early. Fluoride treatment may also be offered to help protect your gums and teeth, so this treatment is usually paid for by insurance.
Dental plan coverage often extends to routine care when a problem is discovered during a checkup. For example, when a cavity is found, the filling is usually paid for by the insurance company. Tooth extractions are also generally covered when they are necessary for the health of the patient’s mouth. Even minor procedures, such as filling a chipped tooth, are often included in dental plan coverage. Crowns, tartar removal, and tooth polishing are also typically included in the category of routine dental procedures, so they’re usually paid for, at least in part, by insurance.
In most cases, mouth surgery is only partially covered by insurance unless the plan is particularly comprehensive, in which case the premium is likely to be quite expensive. For example, most patients pay out-of-pocket for a root canal, although some affordable plans may pay for a portion if medically necessary. Typical dental plan coverage usually includes paying for at least partial dentures, and older patients who anticipate needing them in the near future are usually advised to opt for a plan that covers the full cost of dentures. Typical dental plan coverage pays for at least most of the cost of braces for children, but many do not extend coverage to braces for adults.
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