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A Dentist in Fairfax Explains Why Medical Insurance Doesn’t Cover Dentistry

February 5, 2019

Filed under: Uncategorized — Tags: — fairfaxdental @ 9:46 pm

Happy dental patient in the dental chairHere’s a quandary for you: cataract surgery is covered by medical insurance, but oral surgery is typically not. For that, you’ll need to depend on your dental insurance, but that might not cover the cost of an advanced treatment such as oral surgery. So what’s the catch? Read on for an explanation from a dentist in Fairfax and learn what you can do to encourage medical insurance providers to take oral health more seriously.

Dental History 101

Hard to believe, but some dental professionals hypothesize that physicians and medical insurance providers still don’t consider dentistry a bona fide scientific field. Barely 100 hundred years ago, dentistry was performed by “professionals” with very little training. And less that 200 hundred years ago the barber that cut your hair was often the same person to take care of your oral health. This history may be one reason why medical insurance is still not used to cover even advanced dental treatments.

The Risk of Covering Dental Care

Dental care is markedly different from medicine, and the difference is evident in the way dental insurance is set up. Your dental coverage is designed to encourage you to have regular preventive care. Most providers cover checkups and other preventive services at 80 to 100 percent. However, the most advanced procedures receive much less coverage. The problem is that many people don’t see a dentist in Fairfax until there is a painful problem. When this happens, advanced—and more expensive—treatment is likely necessary. Therefore, many medical insurance providers find that covering dental services is just too high a risk. This is one reason why medical insurance plans don’t cover dentistry.

Dental Procedures That Medical Insurance Covers

There is some good news on the horizon: more medical insurance providers are beginning to consider dental services for coverage. Today, you may be able to use your medical benefits for a number of dental treatments such as:

  • Oral antibiotics, oral sedatives and other prescriptions for dental work are often covered by prescription coverage, which is part of your medical insurance
  • Sedation during a procedure, especially when performed in a hospital, could be covered by medical and dental insurance
  • Sleep apnea appliances
  • TMJ therapies are covered by medical insurance, because the side effects can affect your general health
  • Advanced oral and facial surgeries that are required after a traumatic injury receive partial medical insurance coverage

Hopefully, this explanation cleared up the reason why medical insurance often does not cover dental care. However, your dental insurance does cover preventive dentistry, so be sure to schedule regular checkups with a dentist in Fairfax.


About the Author

Dr. Sanae Berrada is a general, cosmetic and restorative dentist in Fairfax. She and her staff work hard to maximize your dental insurance benefits for every service you receive. When available, medical insurance is used, as well. If you have any other questions about your coverage, she can be reached via her website or at (703) 215-1752.

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