Will a health insurance plan cover my Dental expenses?

Last Updated: Jan 19, 2022 | 26,257 Views

A small white chip came off my tooth while having breakfast today. It concerned me and I rushed to the dentist with the earliest possible appointment. The dentist made a big hole in my tooth and an x-ray in the name of examination and THEN told me that I need to do some Root Canal Treatment and a cap over it, which would make a bigger hole in my pocket than my tooth…. Sigh… I didn’t have an option since my tooth has already been dug out. Thus, I had to undergo the so-called treatment for an itsy bitsy white chip off my tooth…

Well...well… that is the story everywhere. I am being told that it takes about Rs 500 per visit to any dentist, not necessarily the best one, if the dentist has nothing extra to do to the tooth. Any treatment is charged a bomb and billed extra! Out-Patient Dental Treatment, without surgery, can cost upto Rs 15000 – Rs 20000 per tooth or maybe more.

Thus, my new area of interest is Dental Insurance, which is technically designed to pay a portion of the costs associated with dental care. In general, a Dental Insurance Plan covers a percentage of the dental charges incurred at a dental office, and may include free preventative services such as cleanings as well. There is no industry standard annual maximum limitation, deductible, or co-pay. Such coverage and benefit limitations are determined by each insurance company. Dental Insurance has not gained enough importance in India but is very common in the western world. However, having good Dental Insurance can save you quite a few unpleasant surprises -- and definitely a lot of money in the longer run!

But, in India, there are no stand-alone Dental Insurance Policies. Sometimes the Dental Care Product Companies come up with Stand Alone Dental Insurance Plan which covers the expenses related to general dental problems, such as periodontitis and extraction of permanent teeth due to ailments such as caries. The usual Mediclaim Policies cover dental surgery only if it requires a minimum of 24 hours hospitalization and is caused by an accident and not otherwise.

Dental insurance cover that is usually provided is a part of general health insurance plan such as health advantage policy or student medical policy. Through this scheme, one can claim dental expenses along with the other kinds of reimbursements, such as the cost of medicines or hospitalization.

Most health insurance policies exclude dental treatment in their list of common exclusions. However dental surgery and treatment would definitely be covered under certain policies if the same requires a minimum of 24 hours hospitalization and especially if the same is caused by an accident. Among the policies that you can consider to avail which definitely covers dental surgery which requires 24 hours hospitalization would be:

Oriental Insurance Universal Health Insurance Scheme

Royal Sundaram Family Health Policy

But my major concern was Out Patient Treatment, like Root Canal Treatment, etc. If you are looking for cover for dental expenses in OPD, then you can consider Chola MS Advanced Individual Healthline Plan. In that plan, 1% of Sum Insured is paid after a waiting period of 3 years subject to a maximum of Rs. 5,000 once in a block of 2 years with 30% co-payment by insured.

Since I have burnt my finger with dental expenses, I would not like to take the risk of going through the same trouble all over again! I would take up one of these policies which provide for dental care as there are no stand alone dental insurance policies in India, although I sincerely wish there was! So, my dear friend, if you do not wish to get blown away by the sheer magnitude of the possible dental care expenses, you should also hurry up…. To take a health care plan for yourself and your family, I meant!

Deepak Yohannan
Deepak Yohannan is the CEO of MyInsuranceClub. He enjoys writing on Personal Finance and contributes regularly on sites like Reuters & Moneycontrol. He is a strong proponent of online insurance and is often found pointlessly babbling about it!