Insurance companies vary on what they cover and what the amount of coverage they offer. some will pay a percentage of the charge and you are responsible for the rest. On average though, insurance will cover a true dental emergency. Your dental health provider will be able to submit the insurance claim with the appropriate information on it that will tell the insurance examiner what happened and how you were treated. Based on that written information and Xrays they can determine what coverage they will do.
When you sign up for the insurance plan it is advised to read the policy completely and thoroughly so that you understand what is covered. It is also advised to keep a copy in a safe place so you can refer to it if an emergency arises. If you are currently a patient here we will be happy to go over the insurance packet information with you to make sure that you understand the policy and that we accept that insurance.
When you go to the dentist with an emergency, they will check to see if your insurance covers the emergency and look at what information the insurance company will require to approve coverage. At this time, the front office professional will have looked up what percentage you are responsible for and what the insurance company will pay. Usually, they will give this information to you before continuing with the treatment.
This will give you an idea of what you need to pay if anything at all. As a dental office professional, we know what insurance plans usually cover. This is called usual, customary and reasonable coverage.
If needed we will do a palliative (temporary) treatment to get you out of pain until we can send the insurance company the estimation of benefits to see if they will cover it then we will wait to process any charges. Some types of emergencies that may be covered are trauma, unexpected pain from a cavity, pain from a root canal treatment, and any other type of oral health issue that is acute and requiring a dental health professional to look at or treat.
In conclusion, if you have a dental emergency always call our after-hours telephone line and someone will get back to you as soon as possible. We may be able to provide a home treatment that will get you through until regular office hours when you can be sure what the emergency coverage is.