Why are root canals not covered by insurance in 2023? Are you needing a root canal dental procedure but are worried about its potential cost?
You are not alone. When seeking dental insurance, many people are surprised that it does not cover root canal procedures.
It can be frustrating and overwhelming financially, but you don’t need to give up hope.
If you’re facing a root canal, don’t let cost stop you from getting the care you need. Keep reading to find out more!
Note: In this article, we will find out all the facts about why root canals are not covered by insurance and the option through which root canals can be covered through insurance.
In this article, we’ll explore all the facts about root canals not being covered by insurance and discuss some essential options for getting the care you need.
Note: Article Highlights
In this article, we will discuss the three significant aspects of root canal dentistry procedure and the involvement of insurance in it. It is shown below:
1. Why are root canals not covered by insurance?
2. What are the best options for you to control the cost of a root canal if it is not covered by insurance?
3. When is root canal covered through insurance?
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Why are root canals not covered by insurance?
Remove: A root canal is a dental procedure used to remove damaged or infected tissue from inside a tooth.
Recommended: A root canal dental procedure is usually recommended when the pulp which contains the nerves and blood vessels of the tooth becomes inflamed or infected.
Effective: Root canals are an effective way of saving a damaged tooth and preventing the need for extraction; however, the cost of this dental procedure can be high.
Elective or cosmetic: Many insurance plans do not cover the cost of a root canal treatment procedure. This is because this dental procedure is considered elective or cosmetic in nature rather than medically necessary.
Life-saving: Insurance companies do not consider root canal dental procedures life-saving and therefore do not see the need to cover its cost.
Restorative dentistry: Another reason root canals are not covered by insurance is that this dental procedure is considered a form of restorative dentistry.
Restore: Medically this means that the root canal dental procedure is used to restore the function and appearance of a damaged tooth rather than to prevent or treat disease.
Considered: Insurance often does not cover restorative dental procedures because they are considered discretionary or elective.
What are the best options for you to control the cost of a root canal if it is not covered by insurance?
Exorbitant: The cost of root canal dental procedure can be exorbitant and it becomes more overwhelming for those who are not able to afford the procedure.
Afford: In this section, we will understand how the cost of root canal dental procedures can be reduced, so this information is helpful for those who cannot afford the cost of this dental procedure.
Can you use dental insurance and savings plan together?
It is possible to use a savings plan and dental insurance together to help cover the cost of dental procedures. Dental savings plans and dental insurance are two different types programs and that can help make dental care affordable.
Dental savings plan:
Offers: Dental savings plan also known as dental discount plan. It is a membership based program that offers its members discounted rates on dental procedures.
Annual fee: The plan usually has an annual fee and gives members access to discounted rates on a wide range of dental procedures, including X-ray, cleanings, and fillings.
Like dental insurance: These plans usually do not have certain insurance conditions such as deductible waiting periods or annual maximums. They do not cover 100% of preventive care and diagnostic services like dental insurance.
Discount plan: A dental savings plan is also known as a dental discount plan. It is a membership-based program that offers its members discounted rates on dental procedures.
Member’s access: The plan usually has an annual fee and gives members access to discounted rates on various dental procedures, including X-rays, cleanings, and fillings.
Insurance conditions: These plans usually do not have certain insurance conditions, such as deductible waiting periods or annual maximums. They do not cover 100% of preventive care and diagnostic services like dental insurance.
Are there any government programs that can help with the cost of a root canal?
Financial assistance: A Health Savings Account (HSA) is an excellent dental financial assistance program for individuals suffering from tooth decay who do not have the money to pay for expensive treatments such as dentures, extractions, fillings, and root canals.
Denti-Cal: Some states have their own dental care assistance schemes. For example, the state of California has a programme called Denti-Cal that offers low-income children, adults, and expectant women access to dental care.
Any programs: You should check with your state’s dental board or Medicaid office to see if they have any programs to help with the cost of a root canal.
Are there any dental schools that offer discounted root canals to patients?
Under license: Some dental schools may offer discounted root canals to patients as part of their clinical training program. Dental treatment is usually performed under licensed dentists and dental faculty supervision.
For example: The Los Angeles School of Dentistry (UCLA) and the University of California have clinics that provide a wide range of dental services at low fees.
The clinic is staffed by dental students, residents, and faculty and provides dental orthodontics, periodontics, and oral surgery services, including root canals.
Appointment: The facility is available on a first-come, first-served basis, so readers should be aware that they might need to wait for an appointment.
Are there any options for financing a root canal if insurance doesn’t cover it?
CareCredit: CareCredit is a healthcare credit card that you can use to pay for a root canal or other dental procedures. You can apply for CareCredit and, if approved, then use it to pay for the root canal and then pay monthly.
Dental savings plans: Dental savings plans are a viable alternative to traditional dental insurance. So they are less expensive and can be used to pay for root canal dental procedures.
Personal loans: Financing a root canal dental procedure with a personal loan can be a good option. Some individuals take this task with ease. If you have good credit and can qualify for a loan with a lower interest rate.
Payment plans: Some dental offices offer payment plans that may allow you to pay for a root canal over time. This plan is helpful if you cannot pay for the root canal dental procedure in one go,
When is root canal covered through insurance?
Medically necessary: When it is considered medically necessary, root canal dental treatment is usually covered by insurance.
Depend: Coverage for root canal dentistry varies depending on the individual’s insurance plan.
Under basic: Technically root canal dentistry can be covered under basic dental insurance plans.
Become: A root canal may be considered a necessary dental procedure when the pulp inside the tooth becomes infected or inflamed.
Further: Dental insurance may usually cover root canal dental treatment as a preventive measure to avoid further complications.
Save: A root canal is considered an essential dental procedure to save a severely infected or damaged tooth.
Major and minor: As both major and minor restorative procedures, root canal dental procedures are usually covered under insurance plans.
Specific policy: Root canal dental coverage depends on the specific policy and the individual’s dental insurance plan.
Benefit: Root canal dental treatment can usually be considered a covered benefit under dental insurance policies.
Necessary: Insurance companies usually cover a root canal if it is deemed necessary to maintain the tooth’s health.
Eliminate: Root canals are usually covered under dental insurance if the dental procedure is needed to eliminate inflammation or infection.
Spread: If necessary, insurance covers root canal dental procedures to prevent the spread of infection or ease pain.
How do you know if you need an emergency root canal?
Sign: Sensitivity or severe tooth pain is a common sign that a root canal may be necessary.
Tenderness or swelling: Tenderness or swelling in the gums near the affected tooth may also indicate the need for a root canal dental procedure.
Discoloration: A darkening or discoloration of the teeth can be a sign of infected or damaged pulp.
Recurring pimples: Persistent or recurring pimples on the gums near the affected tooth may indicate an infection requiring a root canal dental procedure.
Become loose: A tooth changing its position or has become loose can also indicate the need for a root canal.
Biting or chewing: Persistent and severe pain when biting or chewing indicates the need for a root canal.
Injury: If the tooth has been damaged due to trauma or injury, then a root canal dental procedure is required to save the tooth.
Fever: If you have a fever with a toothache, it could be a sign of an infection. That may require a root canal dental procedure.
Bad taste: If you have persistent bad breath or a bad taste, it could be a sign of an infected tooth that needs a root canal.
Cold or hot: If your tooth is sensitive to cold or hot temperatures and persists for a long time, it is a sign of infected pulp and requires a root canal dental procedure.
Cheeks and Jaw: If the toothache is accompanied by swelling of the cheeks, jaw, or face, it may be a sign of infection that requires a root canal dental procedure.
Medicines: If you have a toothache that does not go away with the use of medicines, this is a sign that you need a root canal dental procedure.
History: You are at higher risk of needing a root canal if you have a history of gum disease.
How long do root canals last?
A broken or infected tooth can be permanently fixed with a root canal dental procedure. However, the longevity of a root canal procedure might vary depending on a number of circumstances.
Well-performed: A well-performed root canal dental procedure is likely to last longer.
Crown: A tooth restored with a crown will have a longer life span than a tooth restored with a filling.
Hygienic care: Regular dental exams and hygiene practises like brushing and flossing can extend the life of a root canal dental operation.
Affect: A root canal’s ability to heal and last a long time can be affected by several fatal disorders, including as diabetes or autoimmune diseases.
Stress: Habits like chewing on hard objects or grinding teeth can put unnecessary stress on the treated tooth, which affects its longevity.
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Frequently Ask Questions:
At what point is a root canal not an option?
Heavily decayed or damaged: A root canal is not a good option if the tooth is heavily decayed or damaged. If the tooth has a large crack or is broken down to the point where there is not enough tooth structure left to support the filling, a root canal may not be possible.
Effectively: If the tooth is severely infected, a root canal dental procedure may not be able to effectively clean out all of the infected tissue.
Is there an alternative for a root canal?
Alternative: Root canals are an alternative to dental procedures. One option is to remove the tooth and replace it with a bridge, implant or denture.
Are root canals caused by poor hygiene?
Root canals are usually not caused by poor hygiene but by a deep tooth crack or decay. Poor oral hygiene leads to a build-up of plaque and bacteria that cause tooth decay.
Root canal dentistry procedures are often not covered by insurance because they are considered a form of alternative or cosmetic dentistry. Therefore, a root canals dental procedure is not considered medically necessary and is not covered by most insurance plans.
But you haven’t lost everything. Options are available to help you factor in the cost of a root canal. You can look into government programs, access dental savings plans, or even negotiate with your dentist for a lower cost.