Will Your Dental Insurance Cover Dental Emergencies? Here’s What You Should Know

October 15, 2024

Patient checking their dental insurance for dental emergencies

Unfortunately, dental emergencies don’t cooperate with your schedule. They simply pencil themselves in whenever it suits them! So, when a dental emergency strikes, whether it’s a sudden toothache or a broken molar, your first thought is usually getting relief. However, quickly afterward, your next question will probably be “Can I afford it?” This is usually where dental insurance comes in, but will it cover an emergency visit? Continue reading to break down the basics of dental insurance coverage for emergency appointments so you know what to expect.

What Counts as a Dental Emergency?

First, it’s important to understand what qualifies as an emergency, especially when it comes to insurance policies. Dental emergencies typically involve situations where immediate care is needed to alleviate pain, prevent infection, or save a tooth. For example:

  • Severe toothaches
  • Broken or chipped teeth
  • Knocked-out teeth
  • Abscesses or infections
  • Injuries to the mouth or gums

If you’re experiencing one of these issues, it’s best to call your dentist as soon as possible to keep the situation from getting worse!

Does Dental Insurance Cover Dental Emergencies?

It’s difficult to say with certainty, however, most dental insurance plans do have provisions for emergency treatment. Still, the answer depends on your specific policy. Here are some things to look out for:

Your Plan’s Coverage Limits

Many dental insurance plans cover emergency exams and necessary X-rays. However, coverage for treatments, such as root canals or extractions, may be limited. Some plans might cover temporary fillings, pain relief, or antibiotics for infections. It’s a good idea to check your benefits and coverage limits often so you can be prepared.

Deductibles and Co-Payments

Even if your insurance covers emergency visits, you may still be responsible for paying a deductible or co-payment. Most plans require that you meet an annual deductible before they begin covering costs, so it’s important to know where you stand on a regular basis.

In-Network vs. Out-of-Network Providers

Some insurance plans cover emergency visits only if you see an in-network dentist. If you visit an out-of-network provider, you might have to pay more out of pocket. If you have an emergency while traveling, your plan may also provide special provisions for out-of-network care. It’s best to review these kinds of provisions to avoid unexpected costs.

Dealing with a dental emergency is never fun, no matter when it happens! However, being knowledgeable about your policy can help you get the care you need without stress. When in doubt, reach out to your friendly dental team or your insurance provider to clarify your coverage and ensure you’re prepared for anything!

About the Practice

At Langworthy Family Dentistry, Dr. Kristen Langworthy and Dr. Mariya Harn provide compassionate care for dental emergencies of all kinds. Their team is happy to help you navigate your insurance benefits and ensure you get the treatment you need when it matters most. Call (919) 762-6887 to schedule an emergency visit with us or visit our website to learn more about the treatments and services we offer.