If you have read some of our past blogs, you will know that most dental insurance companies haven’t raised their dental benefit levels since their inception back in the mid-1960’s. The maximums were $1000 a year back then, and most continue to be $1000 today.
The dental insurance companies keep raising their premiums, and the fees of the dental procedures as cost of living and inflation goes up, but the yearly maximum has stayed stagnant at right around $1000 for the last 50 years.
To get an idea of how things have changed since the beginning of dental benefits and now, the cost of a new house back in 1965 was $13,600, the cost of a new car was $2,650, and the average income was $6,450 a year. Back then, $1000 covered a lot of dentistry, but today, it barely covers procedures needed to treat one tooth.
More and more dental offices these days are turning toward medical insurance to help their patients supplement the dental treatment they need. This was very rare a few years ago, but many offices have learned that almost all of the medical insurance companies will pay out for procedures done in a dental office, as long as the procedures fall under the scope of the dentist’s license.
Since a lot of dental offices don’t bill anything to medical insurance, most patients don’t know that they can use their medical insurance toward their dental treatment. It can get tricky at times because not every procedure can be billed to medical insurance. The following procedures though, can:
Exams and Consultations
Whether it be a new patient exam, a periodic exam that is done in conjunction with a cleaning appointment, an emergency/limited exam, or a consultation, these can all be sent to medical insurance.
Any x-rays taken in a dental office can be sent to medical insurance because they are diagnostic in nature.
Cone Beam CT Scans
Cone Beam CT Scans are usually taken in conjunction with the need for an implant or to extract wisdom teeth, these are also diagnostic in nature, so can also be sent to medical insurance.
Not all oral surgery is done by an oral surgeon. While oral surgeons have been billing medical insurance for years, some things done in a general dental practice can also be sent to medical insurance. Any type of extraction, including wisdom teeth can be sent to medical insurance, as well as any type of bone graft.
Any procedure that is done in a dental office that is a result of any type of accident (car accident, workman’s comp, etc.) can be billed to medical insurance, whether they are dental in nature or not. For example, if you break a couple of teeth in a car accident, one tooth needing a filling and the other a crown, both of these procedures can be sent to medical insurance because they were caused by the trauma from the accident.
Night Guards are very effective for people who clench and grind their teeth at night. These guards protect the teeth, and even the restorations like crowns and fillings against harmful night time grinding and clenching. These guards are considered medical equipment by medical insurance companies, and often times are paid for at 100%, rather than the 80% or 50% that dental insurance usually pays.
OSA (Obstructive Sleep Apnea) Appliances
There have been a lot of advances in dentistry over the past decade, but none more-so than for Obstructive Sleep Apnea. Before these advances, most people needed to be hooked up to a large and invasive CPAP machine. With the advances that have been made, sleep apnea can (most of the time) be managed by wearing an appliance very similar to the night guard mentioned above, and is a lot more comfortable to wear than the facemask to a CPAP machine.
These appliances are also considered medical equipment, much like the night guards are, and are covered at 100% a lot of times as well. Although in most cases a sleep study is required to prove medical necessity, but one can be obtained very easily.
Bring your medical insurance card to your next dental visit to see if you can take advantage of using your medical insurance to supplement your dental treatment. Doing so will open up your dental benefits so that you can apply them to procedures that are more dental in nature like crowns, root canals, and dental implants. Call 602-993-4200 today or visit our website to see how we can help you use your medical insurance at the dental office.