Dealing with a dental emergency is awful enough as it is, but what can you do if your insurance doesn’t cover dental emergencies?
To help you better understand emergency dental insurance, we’ve compiled information on how to get coverage for emergency services and how to better afford treatment.
Dental emergencies are unexpected problems with your teeth or jaw that require urgent treatment.
A dental emergency may require a trip to your regular dentist, an after-hours clinic or the emergency room for the correct treatment.
If you don’t have dental benefits, there are several types of free or low-cost clinics, including dental schools, charities, and taxpayer-funded services.
Credit and payment plans are other options if you do not have a suitable dental plan.
Practicing dental hygiene and avoiding contact sports can help to prevent emergencies.
A dental emergency is an unexpected dental health problem that requires immediate treatment. Common dental emergencies include:
The term “extreme dental emergency” may describe any emergency or only the most serious issues such as fractures or life-threatening infections. Every day or workplace accidents such as falling; car accidents or even biting on a hard object can lead to dental emergencies.
If you have insurance, your coverage for the necessary treatment will likely vary depending on the nature of the care you need. Click here to read more about dental insurance plan levels and how they affect your level of coverage by treatment.
Not every dentist is available for emergency treatment, and it can be even more difficult to find a dentist during closed hours. However, many dentists will give you contact details of after-hours or on-call substitutes when they are not available.
In some cases, you may need to visit the hospital instead. Fractures, jaw dislocations, serious cuts, and infections, particularly if they are affecting your ability to breathe or swallow, require a hospital visit. This will mean your health insurance is billed. Dentists can, however, handle a broken or lost tooth, cavities, and abscesses.
If you only have health insurance with no dental coverage, you won’t get a tooth re-inserted or pulled, or receive any other treatment beyond painkillers and antibiotics in a hospital. Only dentists are legally allowed to perform dental procedures.
If you have dental health insurance, you may find that your insurance company has a provision for emergency services. For example, plan information from Delta Dental describes an emergency provision, even if you are far from your regular dentist. These may not apply to out-of-network dentists.
Dental plans have varying coverage for emergencies, so it is best to read all the fine print. Consider changing your plan if emergency dental issues aren’t covered to the extent that you may need.
If you do not have coverage because you are still researching dental plans, read more on how to choose a dental insurance plan.
If all insurance plans are out of your price range, there’s no need to worry, as most states extend emergency dental treatment to adults enrolled for Medicaid.
Eligibility criteria for Medicaid can include being a member of a low-income family, including if you are pregnant, and having certain disabilities. Today, most US states consider all adults earning less than 133% of the federal poverty level as eligible for Medicaid.
You can check out the following options for emergency dental care without the need for insurance:
Whether you cannot afford dental benefits, or your dental plan has a waiting period that you haven’t yet met for the care you need, there are options. Some have eligibility criteria involving age, income, or disability, while others are available to anyone.
There are several online directories that can help you find an emergency dentist in your local area. Emergency Dental Services not only provides a directory by location, but may also assist you in accessing finances to pay for your treatment.
If you live in Colorado, Iowa, Florida, Minnesota, Nebraska, Oregon, South Carolina, Texas, Virginia, or Washington, you may have an Emergency Dental Care USA office near you. Most can treat walk-in patients on the same day, including on weekends and holidays.
With competitively-priced examinations, diagnostics, and treatment, this dental practice chain will explain all of your expenses, including out-of-pocket costs, before you start treatment. If you don’t have insurance, Emergency Dental Care USA outlines the ways you can access financing options and payment plans.
One way of paying for dental treatment at this and other clinics is a CareCredit card. CareCredit has no upfront costs and low monthly fees and can be used for all dental procedures. They also accept cash, cheques, credit cards, and debit cards; some offices have in-house financing, which requires a 40% down payment.
FreeDental.org and DentalAssistance.us host directories for free dental clinics around the USA. However, some entries only offer dental care for children through the Children’s Health Insurance Program (CHIP), or low-cost dental care through Medicaid. Depending on your needs, always read the fine print before making an appointment.
Additionally, some religious organizations, charities, and even professional associations will donate dental services. They typically have criteria such as income cutoffs, or they may only serve specific age groups or health conditions.
Public dental clinics receive funding from taxpayers or regular grants, so they can offer services ranging from preventive care and basic services to crowns and often emergency dental services.
Public clinics are suitable if you cannot afford dental plans that meet your needs. Eligible patients must earn no more than double the US Census Bureau’s federal poverty threshold, so you may not be able to get an appointment if you just haven’t met the waiting period of your dental plan.
Dental schools often run clinics at no fee or a reduced cost to the patient, allowing dental students to practice. Although the lower costs are due to the students’ lower level of experience, they will be supervised, so you don’t have to worry about major risks to the safety and quality of care.
To find your nearest dental schools, research universities that offer dental programs near you. There may be some criteria for who can receive cheaper dental work, and schools may have waiting lists or limited spaces for emergency care.
The Dental Lifeline Network is a non-profit organization that provides dental treatment, from preventive care and basic services to major treatment, under strict criteria. Besides being unable to afford treatment or dental benefits, you must be aged 65 or older; have a permanent disability, or be considered medically fragile.
Mission of Mercy is an initiative by America’s Dentist Care Foundation, which hosts pop-up, two-day dental clinics in places including schools and fairgrounds. As these are temporary, you have to search for upcoming or current dates and locations. Some also only treat children or adults, so reading all the fine print is necessary.
Sometimes, dentists will reserve a few spaces each year for pro bono cases. These can be for patients of other dentists who need care at a reduced cost. You may find that your dentist will refer you for a pro bono treatment if you explain your financial situation.
To assist in building up your emergency fund for unexpected medical costs or ensure your dental insurance will provide coverage, here are some other ways to save money:
Most dental insurance plans have an annual maximum, which is usually between $1,000 and $2,000. From here, all of your expenses are out-of-pocket.
Practicing good oral hygiene is the best way to maintain healthy teeth, preventing cavities, gum disease, and the need for root canals. This can also prevent your annual maximum from being met. Additionally, many dental insurance plans won’t cover treatment, including major services, for pre-existing conditions.
Besides your personal hygiene, regular dental visits for preventive services such as annual cleanings can prevent the need for major dental procedures like root canals later.
If you are still researching insurance policies, it’s important to know that some types of dental insurance prioritize preventive dental care over other procedures.
Contact sports can lead to teeth and jaw injuries, from a direct impact or as the result of biting down as you fall. Your insurance company may also increase your monthly premiums if you report playing contact sports.
Remember to always wear a quality mouth guard and never train while tired or under the influence of any substance.
Cosmetic procedures such as teeth whitening, braces (unless there is a medical need), and veneers are usually not covered by dental insurance plans. As you are likely to have more out-of-pocket costs from seeking these procedures, reconsider your need to have them.
There are, however, certain types of dental insurance that will cover cosmetic services, such as dental discount plans. These do not have deductibles or annual maximums, but won’t provide complete coverage for any service. Instead, you will receive varying discount rates, generally between 10% and 60%.
If you struggle to pay for dental care and don’t have dental coverage, be honest with your dentist about your financial situation. They may be able to refer you to someone who has free appointments available or know of other clinics such as public or charity-funded organizations that offer low-cost dental care.
How can we find affordable care during a dental emergency?
Dental emergencies can result in days or weeks of pain, inconvenience, and missed days at work. They are especially damaging if you are living on a low income, as one lost paycheck can have a number of ripple effects. Fortunately, there is a range of options for prompt, quality dental care whether or not you have insurance.
Your dentist may be able to treat you themselves or refer you. There are clinics dedicated to emergency services, and some problems can be treated in the emergency room. For low incomes or people without insurance, free or low-cost options including dental schools and government-funded clinics are available.
Navigating the complexities of emergency dental insurance can be daunting, especially when faced with an urgent dental issue that requires immediate attention. Understanding your options for emergency dental care is crucial, whether you have insurance coverage or not. For those without insurance, exploring free or low-cost clinics, dental schools, and various financing options can provide a pathway to receiving the care you need without breaking the bank. Additionally, practicing preventive dental hygiene and taking precautions during activities can help avoid dental emergencies altogether.
However, when an emergency arises, knowing the specifics of your insurance coverage and the availability of emergency dental services in your area is essential. For more detailed guidance on navigating the legal aspects of dental insurance and emergency care, consulting insightful legal resources can offer clarity and peace of mind during stressful situations.