You can see which plans include dental coverage by comparing them.
Health insurance
plans may cover dental care, but it may depend on your age and your plan. Under the Affordable Care Act (ACA), dental coverage is considered an “essential health benefit,” but only for children. This means that if you are purchasing health coverage for a person 18 or younger, dental coverage must be available as part of a health plan or as a stand-alone plan.Keep in mind that while a dentist for children must be available, it doesn't mean you're required to buy it. Your dental health can affect the rest of your body and your overall health can affect your oral health. When you need a serious dental procedure, such as oral surgery, some of the costs may be covered by both your dental insurance plan and your health insurance plan. Whether or not your health insurance covers a procedure related to your teeth depends on your insurance provider and plan coverage.
In most cases, health insurance plans will cover some important oral surgery procedures. Or, you can search on our home page. You can also call our Customer Service Center at 1-855-355-5777 for more information about New York's state of health. Monday through Friday from 8 a.m.
to 8 p.m., Saturday from 9 a.m. to 13 p.m. However, the process for filing medical claims is different and may be more difficult than the dental insurance claim process. Oral surgeons and other dental specialists, as well as general dentists, can bill health insurance for certain procedures.
That said, submitting your requests for oral surgery to your health plan can be a good way to increase your money on health care. Costs may be covered for the diagnosis, treatment, or prevention of a medical-related oral condition or for the rehabilitation of lost skills related to the problem. Be sure to do the same with your dental insurance provider, as they can provide a higher level of coverage for such a procedure. You can also talk directly with your health insurance provider to see if your procedure is covered, get an estimate of how much you'll pay, and get a better idea of the out-of-pocket costs you can expect.
Your health insurance may also cover all or part of the cost of medical-related oral surgery procedures, depending on your plan, health condition, and the type and degree of difficulty of the surgery. In this case, it's best to talk to an insurance specialist or your health plan to determine which plan is primarily responsible for related dental care. When you compare dental plans on the Marketplace, you'll find details about the costs, copays, deductibles and services covered by each plan. Also, keep in mind that health insurance may include high deductibles that may need to be paid before any payment is made.
You should always talk to your health professionals for information about diagnosis and treatment, including information about what medications or treatments may be right for you. Unlike dental insurance, health insurance only covers dental treatments if you've suffered trauma, such as an accident or injury, or if you have a medical condition affecting your mouth. It's important to note that if your accident involved a motor vehicle, dental treatment may be covered by car insurance.
