Why Is Dental Not Covered By Health Insurance
Updated On Jul 12, 2022
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Most health insurance policies, typically, don’t provide dental coverage, though it’s mostly available in case of accidents. Under accidental and illness hospitalisation cover, medical expenses incurred due to any necessary dental treatment undertaken as a result of an accident is covered.
Offered By Only A Few Companies
Only some health insurance plans have dental insurance benefits built in. For example, Activ Health Platinum Enhanced Plan by Aditya Birla Health Insurance covers dental consultation and investigation as additional benefits available on a sum insured of Rs 15 lakh and above.
Bajaj Allianz Health Guard Gold plan provides an in-built coverage for dental treatment, including examinations, fillings (where appropriate), crowns, extractions and surgery, excluding any form of cosmetic surgery or implants. Chola MS Privilege Healthline Plan offers OPD treatment for dental treatment up to Rs 10,000 at an interval of every two years.
However, in other comprehensive health insurance plans, dental insurance is covered in case of an accident and when it is recommended by doctors as part of the treatment.
There are also no specific plans which provide dental insurance. “Since dental treatment is considered as planned and can be seen as cosmetic surgery, there are no bespoke plans available for dental treatment. Thus, one can opt for dental insurance coverage which is a part of your health insurance plan. As mentioned above, only some health insurance policies provide this, so if you want a dental insurance policy, you have to choose among a few options.
Covered Under OPD Benefit
Dental benefits are also usually covered if someone has opted for an out-patient (OPD) benefit as part of their health plan. Out-patient dental treatment usually covers expenses related to X-rays, extractions, amalgam or composite fillings, root canal treatments and related drugs prescription, and teeth alignment for adolescents.
However, cosmetic surgery, dentures, dental prosthesis, dental implants, orthodontics, orthognathic surgery, jaw alignment or treatment for temporomandibular (jaw), or upper and lower jawbone surgery and surgery related to the temporomandibular (jaw), unless necessitated by an acute traumatic injury or cancer, is not covered.
Conclusion
It is important to note that the dental treatment facility comes with a certain waiting period and a limited sum insured. Waiting period is that interval until which a specific illness or disease is not covered under a policy.
The best way to cover dental issues in a health insurance plan is to select an appropriate plan that offers a lesser waiting period and higher sum insured for dental treatment. One should always check the limit on the sum insured allotted for the dental treatment because there can be some treatments that are time taking and require a bigger amount.
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