Will My Insurance Cover Sedation Dentistry?



People that are excited to go to the dentist are like unicorns: some claim that they exist, but no one has seen one in real life. And, understandably so. What can be so exciting about having to sit for hours on end in an uncomfortable position while someone uses scary-looking utensils to fix your teeth? Add fear into the mix or a lightheaded feeling whenever you see a needle, and you can see why so many people postpone going to the dentist as long as possible.


That’s where sedation dentistry can be of great help. Whether it's minimal, moderate, deep or general anesthesia, sedation can help you get the treatment you need if you are afraid of the dentist or have to sit for long hours through complex procedures. Talk with your St. Louis sedation dentist to determine which course of treatment best suits your needs.

However, here's a good question: does your insurance cover sedation dentistry or do you have to pay out of your pocket?



Types of Sedation Dentistry


Before answering that question, it is important to understand the different types of sedation that one can undergo.

Minimal Sedation: This type of sedation can affect the patient’s cognitive functions, but he will be able to speak and respond to commands. Also, minimal sedation has no effect on breathing and cardiovascular functions

Conscious Sedation: During this type of sedation, the patient can respond purposefully to the doctor's verbal indications. As with the minimal type, breathing and cardiovascular functions aren't affected.

Deep Sedation: This type of sedation affects the patient’s cognitive functions to such a degree that they can only respond to repeated, loud, and painful stimuli. They might need aid in breathing, but the cardiovascular functions usually don't suffer any effects.

General Anesthesia: One important distinction needs to be done here: general anesthesia and sedation are two different things. The former is a drug-induced loss of consciousness during which the patient won't respond even to painful stimuli. Moreover, their breathing and cardiovascular functions are affected and the patients need assistance.

The reason we presented the different types of sedation is that they generally affect the insurance company’s decision to cover the costs.

Will My Insurance Pay for Sedation Dentistry?


More often than not, your insurance won't cover sedation dentistry. Most plans see sedation as a luxury and don't include it in their policies.

There are a few exceptions, though. For instance, if you need to undergo general anesthesia, then your insurance may cover the cost as it is not considered sedation. Moreover, if you have a disability that makes it difficult for you to get proper dental treatment without being sedated, then your insurance may also cover the cost. Even a “dental phobia” diagnosis can qualify as a debilitating condition covered by most dental plans. Be sure to talk with your St. Louis sedation dentist and get informed about your options.


Although your insurance may cover sedation dentistry under certain circumstances, note that you may only get a certain amount per year in treatment costs. You may have to pay the rest out of your pocket.

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