“Medical insurance provides benefits to keep us in good health and rectify health problems which may arise throughout our lives,” says Dr. Bruce Fine of Fine Dental Care in Wayne. “A question that comes up time after time is, are there instances where a dental procedure is covered by medical insurance?”
The distinction between medical insurance and dental insurance is that medical insurance will only cover what the insurance companies deem medically necessary, whereas dental insurance covers dental procedures considered non-medically necessary (by medical insurance companies)—even though those dental procedures may actually be needed to keep someone in good health.
Medical Insurance vs. Dental Insurance:
What May be Covered What procedures medical insurance will cover and under which circumstances can be a confusing ordeal to most of us, but let’s explore examples of dental procedures that may be considered medically necessary and therefore, possibly covered by medical insurance.
For instance, medical insurance generally won’t pay for fillings, because fillings are considered a dental procedure. However, if say, someone has tooth decay because their mouth became too dry as a result of chemo therapy, their fillings may be covered under a medical plan since correcting their oral condition could be considered medically necessary.
If someone had: gum disease because of a bone disorder; surgery that involved diseases to facial bones; facial deformities corrected; or treatment of jaw disorders, dental procedures may be deemed medically necessary to their treatment.
Teeth injured in a car accident may be covered by medical insurance because the damage was caused by the accident, and not a dental problem.
Sleep apnea appliances may be covered by medical insurance, along with procedures due to TMJ. Even some oral surgeries may be considered medically necessary.
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The main thing to keep in mind while researching if a certain dental procedure is covered by medical insurance is to ask yourself this question: “Is the issue a medical issue or a dental issue?” Look closely at each of your medical insurance policies, and you might just find things that you didn’t realize were covered.
If you have any questions about medical insurance coverage and how it relates to a dental procedure, call Dr. Fine’s office, “Fine Dental Care”, at (973) 587.8011. Or for more information, visit www.finedentalcare.com