Will My Dental Insurance Cover an Emergency Visit?

Dental emergencies can happen any time or any place—and they have a funny knack for happening when it’s least convenient! But amidst the chaos of sustaining a dental injury, your top priority should be visiting your emergency dentist and getting the care you need. And worrying about your insurance coverage will only make things more stressful! That said, here’s more about how dental insurance works when it comes to emergency dental care.

Three Common Types of Dental Insurance Plans

To better understand what you can expect to pay during an emergency dental visit, you should consider the type of insurance plan you’re enrolled in. The three most common types of plans include:

• Preferred Provider Organization (PPO) – If you have a PPO plan, you have the option to visit a dentist either in or out of your provider’s network; however, you’ll often have lower out-of-pocket costs if you stick with a practice that’s in-network.
• Dental Health Maintenance Organization (DHMO) – DMHO plans work a little differently; in contrast, they require you to visit a dentist that your provider has approved. If you seek care outside of the approved list of specialists, you might not be covered.
• Discount dental plans – These programs provide you with a pre-negotiated rate that you can expect to pay by getting dental care from a select group of dental practices. Even though none of your services are covered, you will get a nice discount on the care you do receive.

Emergency Care: What’s Covered & What Isn’t

If you’re enrolled in a PPO or DHMO plan, you should know that at least a portion of your emergency visit will likely be covered! For example, if you suffer a knocked-out tooth, the cost of the replacement might not be covered—but the cost of diagnostic care (oral examinations, X-rays, etc.) could be. On the other hand, something like root canal therapy and the accompanying crown restoration might be covered by up to 50%. In any case, dental insurance typically covers a wide range of emergency procedures including but not limited to tooth extractions, fillings and crowns, root canals, and more.

How Your Emergency Dentist Can Help

The first and foremost thing that should be on your mind upon suffering a dental emergency is treatment and relief—the total cost shouldn’t be something that makes you sweat! Fortunately, your dentist and their team can work with you to navigate the financial implications of treatment while also focusing primarily on making you feel right again. If you want to take advantage of your benefits, they can even handle all of the paperwork for you and maximize your coverage; you can simply sit back, relax, receive treatment, and save!

About the Author

Dr. Stephanie Lacquaniti received her dental doctorate from the University of Florida College of Dentistry and has proudly served patients and families in the Mt Dora community for several years. Her practice is pleased to offer a wide range of available services including emergency dentistry. If you or a loved one has suffered a dental emergency, don’t hesitate to contact the practice to schedule an appointment: (352) 383-8121.