Do You Need to Buy a Dental Cover With Health Insurance?

December 29, 2021 Mutual Fund

It is crucial to visit your dentist every six months as dental hygiene not only prevents oral diseases it indirectly helps to prevent other health issues as well. Unfortunately, dental treatments are costly, especially when we require major work done. Many leading health insurers in India have started offering dental insurance to help customers cope with dental issues without spending from their pockets. However, most of us do not realise the need for having a dental cover unless we need to visit the dentist after ignoring many early signs of oral health issues.

What is Dental Insurance?

Dental Insurance is a part of health insurance that covers dental procedures that are considered necessary by medical professionals. Hence, cosmetic dentistry is not covered under dental insurance.

Here are a few points you should know about Dental Insurance in India:

The major insurers do not offer exclusive dental insurance coverage in India as dental work falls under the category of cosmetic treatments. A very few health insurance policies offer dental coverage included in their basic health insurance plan, which covers dental treatment arising out of an accident.

However, most insurers offer it as an add-on coverage, which can be purchased with your basic health insurance plan for a slight increase in the premium. Add-on dental coverage is the most popular way of covering your dental issues with insurance in India.

What is covered under Dental Insurance?

Only dental procedures or treatments, whether preventive or diagnostic, deemed necessary by medical professionals are covered under Dental Insurance. Some of the examples are:

• Tooth extraction

• Root canal

• Dentures

• Filling of caries

• Two preventive visits to the dentist during a policy year

• Implant

• Treatment for gum disease

What is not covered under Dental Insurance?

Cosmetic dentistry and pre-existing dental issues are not covered under dental insurance. There could be many more procedures that the dental insurance plan does not cover, which should be checked in the lists of policy exclusions and exemptions.

What are the types of Dental Insurance?

Considering the fact that in India, most insurers offer dental cover as an add-on with their basic health insurance plan, we will focus only on this type of dental insurance. Depending on the health insurance plan you choose, your dental insurance can be of several subtypes based on different categories. Here are two basic types of Dental Covers offered with Health Insurance Plans:

1. Reimbursement Dental Cover:

When you buy a dental cover with a health insurance plan that is a reimbursement plan, you are required to pay for the medical expenses from your own pocket and submit the hospital bills along with other necessary documents to the insurance company for the reimbursement of the paid amount. The insurer will verify the claim and reimburse the amount to your registered bank account after deducting all the deductibles, co-payments, etc. With this type of insurance, you can visit any hospital of your choice for treatment.

2. Cashless Dental Cover:

With a cashless claim plan, you do not have to pay for the medical treatment on your own as the insurance company directly settles the claim with the hospital. You are required to show your cashless claim card or insurance papers to the hospital’s insurance department and pay for deductibles and co-payments, if any, for the insurer to proceed with the claim settlement. However, you can only visit the network hospitals of the insurance company to take benefit of the cashless claim settlement facility.

What are the benefits of Dental Insurance?

• The policyholder is motivated to visit the dentist for regular check-ups, which people tend to avoid when they have to pay for it from their pockets.

• All the preventive and diagnostic procedures are covered under dental insurance.

• Dental insurance covers all the dental procedures arising out of an accident. So, if you have to undergo a treatment that falls under the category of cosmetic dentistry, rest assured it will be covered by your insurance.

• Apart from the dental procedures, x-rays and check-ups are also covered under the dental plans.

• Since the insurance covers the cost of treatment, you do not have to compromise on the quality of the treatment, clinic, material such as dentures, implants, braces, etc.

• Dental Insurance plans also cover some minor surgical procedures.

What are the things you should remember before buying a Dental Insurance Plan?

• Dental insurance plan benefits differ from one insurer to another. Hence, while some plans might cover invisible bracing, others might not. Therefore, before purchasing the plan, it is essential to thoroughly evaluate multiple plans and ensure the procedures you are specifically looking for are offered under the plan.

• Since the policy features, benefits, terms and conditions, differ from plan to plan, you should carefully read and understand them to avoid any future disputes.

• It is advisable to check for the deductibles and co-payment clause that comes with most dental insurance plans. The amount or percentage of deductibles and co-payments should not be too high that it becomes a burden to pay at the time of a claim.

• Make sure you buy adequate insurance cover, as not doing so will not serve the purpose of holding a dental insurance plan.

• Compare the policy offerings with the premium and do the cost-benefit analysis. If the premium, deductibles, and co-payments are too high, buying a dental plan does not make sense.

• Instead of looking for a comprehensive dental insurance policy, check for the health insurance policy that offers dental insurance cover as an add-on, which can be bought for a slight increase in your regular health insurance premium.

• Suppose you are planning to buy dental insurance for a pre-existing condition or cosmetic dentistry. In that case, the insurer will not accept your claim as such procedures come under the policy exemptions, which are not covered under the insurance.

To Conclude:

Whether you need to buy a dental cover or not depends on how much you are willing to spend on the annual premium of the dental cover, its offerings, and your requirements. If you are looking for specific procedures that you know are covered under the insurance, then buying dental cover is worth the premium you pay. Moreover, apart from taking the recommendations from friends and family and checking the online reviews of actual customers, it is advisable to take recommendations from your dentist as they can have tie-ups with insurance companies, which can help you get better deals. But, if you think the premium and deductibles are too high, and if you are ready to take the risk of paying for high expenses of the dental procedures; then you should take necessary precautions to keep the oral health in good condition by brushing your teeth twice a day, doing at least two dental check-ups a year, not neglecting the early signs of oral diseases, etc.

This article first appeared on PersonalFN here