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Is Sedation Dentistry Covered by Insurance?

January 12, 2021

Filed under: Uncategorized — beverlyhills @ 6:16 pm
Patient asking dentist, “Is sedation dentistry covered by insurance?”

If it’s been a long time since you’ve been to the dentist, you may feel hesitant about visiting now, especially if the reason you haven’t been in is due to anxiety. If you’re nervous about going to the dentist, sedation dentistry can help. But, will it cost you an arm and a leg? Can you use your insurance to cover it? Well, the answer is not as simple as you might think, so it’s important to keep these factors in mind should you try to put benefits towards sedation dentistry in Century City.

Does Dental Insurance Offer Coverage for Sedation?

Unfortunately, in most cases, dental insurance companies do not offer coverage for sedation dentistry because it is considered to be a “luxury service” similar to cosmetic dentistry or dental implants. Even though it has proven benefits for patients, it is still deemed non-essential, meaning most of the time the costs for this option need to be covered out of pocket. Since sedation can potentially equal the cost of your treatment, many insurance companies note that coverage would require a higher premium.

With that said, there are certain instances where an insurance company may offer coverage. While these circumstances are few and far between, they are worth considering if you absolutely need sedation to complete your procedure.

When Do Insurance Companies Cover Sedation?

If using sedation lowers the cost of your overall treatment, insurance companies may cover some or all of the expenses related to it. Additionally, if your treatment needs to be delayed or spaced out due to your anxiety, an insurance company is more likely to provide coverage for sedation. This is especially the case if you are only receiving mild forms of sedation, such as nitrous oxide. In comparison, IV sedation costs far more, and therefore is less likely to be covered.

If you have a family member that is suffering from a serious medical condition or disability that makes dental care impossible without sedation (i.e. epilepsy, cerebral palsy, autism, etc.), then you may also receive coverage. Furthermore, if the treatment is very complex, (such as oral surgery or multiple tooth extractions) insurance companies may cover some of the sedation costs. With that said, most insurance companies do not consider root canal therapy or dental fillings to be complex. Instead, they are more likely to be classified as “routine treatments,” meaning sedation would need to be paid for out of pocket.

Alternatives to Consider to Pay for Sedation

One option to consider is third-party financing through companies like CareCredit. Services like these make it possible to pay for dental treatments over the course of several months rather than all in one lump sum. This can be a fair solution when you don’t want to change polices and pay higher premiums.

You don’t have to give up on getting coverage for sedation dentistry just yet. It’s always worth it to talk with the dentist directly and confirm all your options ahead of time. Doing so just might help you get you the savings you’re looking for!

About the Author

Dr. Kboudi has over 22 years of experience in the dental field. With that said, he’s always taking the time to expand his skillset in order to provide patients the most comprehensive dentistry possible. This includes offering three different strengths of sedation in his office, including nitrous oxide, oral conscious sedation, and IV sedation. He’ll also help you maximize your dental benefits to the fullest and ensure your treatments can fit within your budget. To schedule an appointment with his office, you can contact him through his website.

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