It’s natural to wonder how much your dental emergency visit will cost. While your main focus may be on stopping the pain, you might be tempted to avoid professional help if you think you cannot afford it. Neglecting treatment will only lead to more serious and costly problems, which is why you can rely on your dental insurance to help. Find out what kind of coverage you can expect when it comes to your emergency visit.
Dental Emergencies & Insurance: What Kind of Coverage is Available?
If you are enrolled in a private dental insurance plan, you can expect there to be different coverage levels based on the type of treatment you need. Generally, you may be responsible for a co-pay or deductible when arriving at your dentist’s office, but the additional fees associated with your care will not be determined until a thorough consultation is conducted by your emergency dentist.
Since many dental insurance companies build their plans on a 100-80-50 scale, you will find that most emergency-based services may be covered at 50-80%. This is dependent on your plan and how they categorize each form of treatment (i.e., root canal, tooth extraction, dental crown, X-rays, etc.).
For example, if you crack a tooth, your dental insurance may cover the total cost of your digital X-rays that are required as part of the initial diagnosis. If your emergency dentist recommends a root canal or tooth extraction, you may be required to pay a portion of the total amount, but your insurance may agree to pay the remaining 50%.
What Factors Are Considered When Determining the Cost of Emergency Care?
You will find that when meeting with your emergency dentist, they will compile their findings to not only provide a recommended form of treatment but also deliver an estimated cost.
The factors they will consider when determining the expected price of your care include:
- The geographic location of the dental office
- The severity of your injury
- The type of restorative care you will need
- How much your dental insurance will cover
Depending on your dentist, they may be in-network with your dental insurance company, which can lead to greater savings. Should they be out-of-network, you can still use your available benefits, but you’ll be required to pay more upfront before a claim is filed to help you receive the maximum reimbursement.
If you are without dental insurance, there is the option of talking to your dentist about alternative payment options, such as flexible financing or enrolling in an in-house membership program if offered.
Dental insurance companies know accidents can happen, which is why they are often ready to help. Don’t be afraid to see your emergency dentist should an injury occur; instead, trust that you’ll be able to get the care you need without the added financial stress.
About the Practice
Westgate Dental Care offers same-day emergency visits for those experiencing dental injuries. As a team of dentists who care about the accessibility and affordability of such treatments, we are pleased to be in-network with most PPOs and will be happy to find ways to maximize a patient’s benefits. If you are concerned about the coverage your dental insurance company offers, visit our website or call us at (847) 908-3684.