What Dental Procedures are Covered by Medical Insurance?

For the past several years, dental insurance companies have been systematically reducing and restricting the kind of procedures that they cover. Many dental claims for surgeries result denials from dental insurance companies asking for a medical EOB and without the medical EOB they ultimately deny patient claims for things like sinus lifts, ridge augmentations, biopsies and more.

Dental Insurance Coverage

Limited dental insurance coverage is becoming more limited and carry many more restrictions, so much so that denial of claims is becoming a common trend in the dental industry and insurance providers are paying out less and less.

However, many medical insurers have started to include coverage for dental procedures in their policies based on medical necessity, which may alleviate some of the financial burden on patients for the surgeries they need. A broad range of treatment availability and easy submission practices, makes medical insurance an appealing alternative.

Common Procedures Covered by Medical Insurance

• Bone Grafting

• Dental Implants

• Wisdom Teeth Extractions

• Excision of a Tumor

• Tissue Grafting

• Any Dental Treatment as a Result of a Traumatic Injury

• Frenectomy

• Osseous Surgery

• Biopsies

• Facial Trauma

• Orthognathic Surgery

• Excision of Bone

• Excision of Cysts/Lesions
  

They also typically include coverage for any procedures which are performed before, during, or after cancer treatment.

In Conclusion

With current financial strains that include higher interest rates, rising inflation, and a more expensive cost of living, many dental patients have been forced to reconsider their dental insurance coverage, and rejected treatments are a factor. High policy cancellations are being driven by claims denials and high premiums, causing patients to question the value of their coverage.

Given the current financial state of affairs, medical insurance could pick up where dental insurance is quickly dropping off. As medical policies become more inclusive and cover a wider range of treatment including dental work, patients are gravitating to dental practices who can/will submit claims to their medical insurance.