Will Your Dental Insurance Cover an Emergency Visit?

March 21, 2024

Filed under: Uncategorized — crsmile @ 10:26 am
A woman suffering from a dental emergency

All in all, a dental emergency is bad enough on its own. The situation can leave you frazzled and scrambling for the nearest dentist. So, you don’t want to find yourself worrying, “Will dental insurance cover an emergency visit?” Leaving this question unanswered just adds to your stress. Luckily, your Rock Hill dental practice can address your concerns. Read on to learn how and why dental insurance can cover a trip to the emergency dentist.

Remember the 100-80-50 Rule

In fact, many dental plans do cover urgent oral care. Plan providers tend to view it as an essential expense. That said, you’ll likely owe a deductible or co-pay for treatment. Most coverage for dental emergencies sticks to the 100-80-50 rule. This guideline divides covered care into three categories:

  • Preventive Services – Preventive services are almost always covered at 100%. These include dental checkups, teeth cleanings, oral X-rays, etc.
  • Basic Procedures – Coverage usually reaches 80% for simple or “basic” procedures. That number would apply to dental fillings, root canals, and simple extractions.
  • Major Procedures – Major procedures like bridges and implants get the least coverage. Most plans cover about 50% of their cost.

Given the rule above, insurance should cover your emergency care. It’ll pay off at least some of any basic and major procedures you get.

Note the Kind of Dental Plan You Have

Aside from the 100-80-50 rule, take note of your specific dental plan. The kind you have will affect how much you pay for your urgent care.

Today, most dental plans are either PPOs or DHMOs. A PPO will let you see dentists in and out of the provider’s network, but the co-pay is lower when you stay in-network. Meanwhile, a DHMO only covers dentists that your provider approves of. Any care outside that group won’t qualify for coverage.

Consider Other Financing Options

With or without insurance, there are other ways to finance urgent oral care. The most notable of these are a dental practice’s payment options. With the right one, your emergency visit can easily fit your budget.

For instance, find out if a dentist has an in-house membership plan. This option would give you discounts on (among other things) urgent services. In exchange, you’d simply need to pay a moderate annual fee.

You could also consider flexible financing. Many dentists now work with third-party financiers, who help patients pay for care monthly. With this setup, you could slowly cover the cost of your dental emergency.

Dental insurance should cover an emergency visit. However, talk to your dental provider to get more exact details.

About the Practice

Coombs, Ross & Sourlis Family Dentistry is based in Rock Hill, SC. Led by its three amazing and skillful dentists, our practice gives each patient the best dental care possible. That means we offer custom treatments that span preventive, cosmetic, and restorative dentistry. Plus, our office is well-equipped to handle all sorts of dental emergencies. For more details or to book a visit, you can reach us on our website or by phone at (803)-592-6201.

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