Dental emergencies often happen when you least expect them. One moment you’re enjoying a snack, and the next, you’re wincing in pain after biting down on something hard. In such cases, your first thought might be to contact your emergency dentist. But before scheduling that appointment, you may wonder: will dental insurance cover the cost of an emergency visit? Here’s what you need to know!
Types of Dental Insurance Plans
Understanding the type of dental insurance plan you have is essential to knowing what your out-of-pocket costs will be for emergency care. Here’s a brief overview of the three common types of dental insurance plans:
- Preferred Provider Organization (PPO): With a PPO plan, you have the flexibility to visit dentists both in and out of your insurance network. However, sticking with an in-network provider usually results in lower out-of-pocket costs. If you choose an out-of-network dentist, you may still receive some coverage but at a higher cost.
- Dental Health Maintenance Organization (DHMO): A DHMO plan requires you to visit dentists approved by your provider. If you seek care outside of the approved network, you might not be eligible for any coverage. This means that in an emergency, it’s crucial to know which providers are part of your plan.
- Discount Dental Plans: These plans do not cover the cost of services but provide a pre-negotiated discount rate at select dental practices. While you won’t have any procedures fully covered, you will still receive a discount on care, making treatment more affordable than paying full price.
Will Dental Insurance Cover Emergency Care?
If you have a PPO or DHMO plan with available benefits, part of your emergency dental visit may be covered. The extent of coverage depends on the type of emergency and the treatments needed.
For instance, diagnostic procedures like X-rays or exams are often covered by most plans. On the other hand, if you need more complex treatments, such as root canal therapy or tooth extraction, your insurance may only cover a portion of the cost. For example, insurance typically covers around 50% of the cost of a restoration like a crown or filling, leaving you responsible for the rest.
However, not all emergency treatments may be covered. For example, replacing a knocked-out tooth may not be fully included in your plan. It’s essential to review your policy or speak with your provider to understand what emergency services are included.
How Your Dentist Can Help
During a dental emergency, the last thing you want to worry about is how to pay for treatment. Most dental offices understand this and will work with you to find a financing option that fits your budget. Your dental team will typically review your insurance policy and help maximize your benefits to reduce out-of-pocket costs. Many practices also offer financing options like CareCredit, which allows you to break up the total cost of your treatment into affordable monthly payments.
About the Practice
Seahurst Park Dentistry is led by the incredibly skilled and experienced Dr. Thomas. Whether you need to rebuild your smile with dental implants or are seeking emergency care, he’ll ensure your treatment goes as smoothly as possible. To learn about your financing options, visit his website or call (206) 244-4622.
