When Does Medical Insurance Cover Dental Work?

LAS VEGAS - May 2, 2024 - PRLog -- In the event of a medical emergency that affects your mouth, the idea of getting necessary care can be stressful, especially if you do not have dental insurance. Fortunately, there are some cases in which your health insurance pays for dental work. Understanding your coverage and knowing whether a service is billed to dental, or health insurance can help you estimate your cost-sharing responsibility.

Health Insurance or Dental Insurance: Which One Pays the Bill?
In most cases, dental insurance pays for routine care such as annual x-rays, cleanings and exams, as well as procedures such as fillings, crowns and bridges. Some plans also provide coverage for orthodontia, which may include braces and implants.

While dental insurance covers most treatments related to the teeth, there are some cases in which your health insurance company foots the bill. If a treatment is medically necessary, the dentist or oral surgeon may file with your health insurance. For example, if you experience a trauma to the mouth during an auto accident, injury or act of violence, your health insurance most likely pays for the treatment.

Determining Whether a Service is a Dental or Medical Procedure
Health insurance pays for certain medical conditions and treatments such as temporomandibular joint (TMJ) and radiation therapy for oral cancer. It also usually pays to treat damage caused by a trauma to the mouth, such as an injury or accident. The exception to this is if you experienced that trauma in a car accident. In this case, your auto insurance plan may pay for treatment as the primary insurance, and your health insurance would be secondary. Who pay's what would depend on your coverages you have on your policies.

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