When you are experiencing a dental emergency, your first thought might be about how you can get out of pain as quickly as possible. Your second thought might be about cost. Will your dental insurance cover an emergency visit to your dentist? While you will have to check your specific policy to see how it applies, we can provide some general guidelines on how insurance generally works in urgent care situations.
Dental Insurance and Emergency Exams
Many dental insurance policies cover one emergency exam per year. The exam may include the time it takes for your dental team to diagnose the problem as well as any necessary X-Rays. Some policies may have different rates for coverage if you visit an out of network doctor or receive care after hours, but in general, insurance plans are quite reliable when it comes to emergency visits.
Dental Insurance and Emergency Treatment
Most insurance policies cover many of the services that may be part of emergency treatment. For example:
- Minor restorative services, which usually include fillings, simple extractions, and other relatively fast treatments, are usually covered at 70 – 80%.
- Major restorative services, which may include root canal therapy, crowns, and surgical extractions, are often covered at 50%.
Of course, it is important to bear in mind that insurance usually comes with a deductible and an annual maximum (the highest amount that your insurer will pay out in a calendar year). In most cases, the maximum is somewhere in the ballpark of $1,000. If the total cost of your emergency treatment exceeds your maximum, you can expect to pay more out of pocket.
Managing the Cost of Emergency Dental Care
Here are a few tips to help you keep your out-of-pocket cost for emergency dental care as low as possible:
- Visit an insurance-friendly practice. Most practices accept PPO insurance, but if you want to enjoy the lowest prices possible, it may be best if you visit one who is in-network with your specific plan.
- Seek care sooner rather than later. Delays may allow a dental problem to get worse, leading to the need for more expensive treatment.
- Know your payment options. Many practices are partnered with CareCredit to offer low-interest financing. Some even have an in-house discount plan for uninsured patients that provides a discount on virtually all services.
- Strive to prevent dental emergencies. Some dental emergencies are the result of inevitable accidents, but most are preventable. Maintaining excellent oral hygiene, properly protecting your teeth during sports, and regularly attending preventive dental appointments are just a few things you can do to lower the risk that you will require urgent care.
Your insurance is likely to cover your emergency care — your dental team will be happy to help you understand and maximize your coverage.
Meet the Practice
New Haven Dental Group in Hamden is home to a talented team of dentists and specialists. We are often able to schedule emergency appointments on a same-day basis, and we are in-network with several major insurance plans. To learn more about us and how we may be able to serve you, contact us at 203-587-7327.