Understanding Dental Exclusions and Limitations
2015 l 2:00 pm

Having dental insurance is almost a luxury nowadays. You get to go to the best dentist near you and get treatment to ensure that your oral health is up to par. From cleanings to extractions, with the right amount of dental insurance, you can ensure that you have one of the best smiles among your friends and family members. Although you have dental insurance, you do have to be mindful of exclusions. Exclusions are dental treatments that are not covered by your dental insurance company. Consider the following typical dental exclusions and limitations.

Cosmetic Dental Procedures

Cosmetic surgery is all the rage nowadays. People want to look their best at all costs. Cosmetic dental procedures offer people the same option, the ability to correct imperfections associated with their mouth. Unfortunately, unlike basic and preventive dental care, cosmetic dental procedures are not covered by your dental insurance provider. Cosmetic dentistry is considered an elective surgery, one you don’t have to have, so your dental provider will not cover these procedures.

Investigative or Experimental Treatments

Investigative or experimental dental treatments are those practices that are not widely accepted in the dental field. These treatments can vary widely and include treatments for oral cancers and other dental procedures. Typically, these treatments have a holistic approach, yet the efficacy of these treatments may not be recognized by the American Dental Association or by your dental insurance provider.

Orthodontic Services

Misalignments are a common problem for individuals with concerns about their teeth. They may want to fix an overbite, a gap, or misaligned teeth, but it’s possible that their dental provider may not cover their condition. Depending on the case, if you are required to visit an orthodontist, you may have to cover the costs of fixing your teeth alone, instead of relying on your dental coverage. However, there are times when your dentist may be able to provide you with the care you need and bill your insurance. The best way to know is to have a dental consultation before undergoing a procedure of this nature.

Fixing Prosthetics and Bridges

After getting a prosthetic tooth or a bridge, it is normal to want to show it off. It’s also normal to want to eat things that you haven’t eaten in a while. However, it is important for you to be careful when you feel the need to utilize your prosthetic tooth or bridge. Typically, dental insurance providers will not replace these items if you damage them within five years. Instead of jeopardizing your smile, make sure you are taking care of it so that you don’t have to cover the costs associated with fixing or repairing it.

There are many other types of dental exclusions and limitations covered in your dental insurance coverage. The best way to know what dental benefits you have is to read the fine print. If you have questions or concerns, talk to your insurance provider as well as your dentist before receiving a procedure so that you will know for sure that the procedure is covered.