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Does Dental Insurance Cover Emergency Visits?

January 9, 2021

Filed under: Uncategorized — suwaneedentist @ 3:57 am
Man with toothache

Many Americans out there have dental benefits through their employer or another means. However, many people don’t fully understand how their benefits come into play. You know that you can head to the dentist for regular cleanings and checkups without a problem, but what if you encounter an unexpected emergency? How much will you owe in order to get urgent treatment from your emergency dentist in Suwanee? Read on to learn more.

What Types of Dental Insurance Plans Are Out There?

Here are the most common options when it comes to dental insurance:

  • Preferred Provider Organization (PPO): This plan allows you the option between a list of dentists that accept the plan or choosing your own dental provider. If you go to a dentist that is out of network, your out-of-pocket costs will typically cost more.
  • Dental Health Maintenance Organization (DHMO): These plans provide a network of dentists that accept the plan for a set co-pay, or no fee at all. However, you much choose one of these dentists and will not receive coverage on ones that are not in-network.
  • Discount Dental Plan: Here you get a discount on dental services from a select group of dentists, but the plan doesn’t cover your care. Instead, the participating dentist will give you a discount on your treatment.

What Do Your Benefits Cover?

Each dental plan is different, so you will need to seek this information from your insurance company to be certain. Here is the typical structure of coverage:

  • 100% of preventive care: This includes checkups, cleanings, and routine x-rays.
  • 80% of basic procedures: Basic services include fillings and periodontal scaling.
  • 50% of major procedures: This includes more complex services like dental implants, dentures, and orthodontic treatment.

Each plan will have a cap on how much it will cover each year, known as your annual maximum. After you reach this, you are fully responsible for all expenses.

Will My Emergency Dental Treatment Be Covered?

This completely depends on the type of emergency that you have and the treatment that you require in order to restore your oral health. For example, if your emergency is due to a cavity and you need a filling, 80% of the treatment will likely be covered by your plan. If you need a more complex procedure, you may be left responsible for half of the costs. You should keep in mind that the longer you put off a dental issue, the worse it will get. If you have the issue dealt with now, you are much more likely to save money in the long run.

If you’re worried about the expenses of dental treatment, it doesn’t hurt to talk to the dental team. They may be able to help with other financial options. Receiving essential dental care shouldn’t mean breaking the bank!

About the Author

At Dentistry at Suwanee, you have two skilled dentists providing quality care to patients in Suwanee, GA. Dr. Katherine Lee earned her DMD from The University of Pittsburgh School of Dental Medicine and Dr. Brian Y. Lee earned his DDS from The University of Michigan School of Dentistry. Together, they opened up their state-of-the-art office over 13 years ago. Their practice is in-network with a variety of popular PPO dental insurance plans. They also have many special offers and discounts available to those without insurance. To learn more about financial options or to schedule an appointment, visit their website or call (678) 381-2875.

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