Why Does Health Insurance Not Cover Dental?

Most health insurance policies don’t cover dental procedures, despite the fact that teeth and gums can have a direct impact on a person’s health. A lot of dental procedures, such as teeth whitening and braces, are seen as not medically necessary.

 

For the most part, preventive care, cosmetic procedures and oral hygiene is seen purely as cosmetic and is not covered under health insurance. If an insurance provider deems a procedure as not necessary for your overall health, it may not be covered. Instead, certain preventive services such as cleanings must be paid out of pocket or covered under a separate dental insurance policy.

 

Are Any Dental Services Covered Under Health Insurance? 

Every health insurance policy is different. It’s critical to speak with your insurance agent to understand the full scope of your policy, including what is covered and what is not. That being said, there are some dental procedures that may be covered under a health insurance policy. These procedures or treatments are primarily seen as health related and include: 

    • Wisdom teeth or 3rd molar extraction 
  • Bone grafts 

  • Dental implants 

  • Biopsies 

  • Headache treatment caused by tooth pain/oral issues 

  • Oral infections, inflammation or cysts 

  • Certain exams directly related to health 

  • Panorex x-rays 

  • Tongue ties for infants and children 

  • Mucositis and stomatitis 

  • Chemotherapy or surgery clearance exams 

  • Accidents (such as if you crash your bike and end up chipping a tooth or jamming it into the gums) 

  • Sleep apnea appliances or dental sleep medicine 

  • Tomography and cone beam 

 

Even Botox injections may be covered so long as they are deemed medically necessary, like in circumstances where you have bruxism or jaw pain.

 

Can You Buy Dental Coverage Outside of Your Work? 

More companies are adding dental insurance as part of their employee packages, but not all of them do. Even if you have health insurance through your employer, you may be able to purchase additional or supplemental coverage such as dental insurance. No one person may have the same exact health issues, and you should make sure to speak with your insurance agent about your policy. 

 

As a rule, the more your policy covers, the more you may pay in monthly premiums. The extra cost may be worth avoiding expensive dental and healthcare bills, however.

 

Oral health and hygiene are a large part of your overall physical wellbeing. Find the policy you need at an affordable price so you and your family can remain healthy.