DENTAL TREATMENT COST may be covered by medical insurance, workmans' compensation, or auto insurance.
What are my options?
Insurance can cover your dental injury treatment.
Treatment for all conditions related to trauma is covered by Medical insurance – not Dental.
If it’s work-related trauma, it may be covered under your Workman’s compensation insurance.
If you have an injury due to an auto accident it may be covered under your auto insurance.
We have great experience and success in obtaining your benefits with all types of insurance.
What are my options?
What dental procedures are covered by medical insurance?
Medical insurance and dental insurance are typically separate entities, and what they cover can vary widely depending on the policy, the insurance provider, and the region you’re in. However, there are some dental procedures that medical insurance may cover under specific circumstances, especially if the procedure is medically necessary and not primarily for dental health or cosmetic reasons. Here are some examples:
Accidents and Trauma: If you’ve had a traumatic injury that affected your teeth, jaws, or mouth, medical insurance might cover treatment costs. For instance, if you were involved in an accident and broke your jaw or teeth, the medical treatment might be covered by your health insurance rather than dental insurance.
Oral Surgery: Some oral surgeries, particularly those that are not routine extractions or dental implants, might be covered by medical insurance. For example, surgeries to correct significant jaw abnormalities, tumor removals, or biopsies may be covered.
Hospital Stays: If you need to stay in a hospital due to a dental infection or another dental-related issue that has broad health implications, your medical insurance might cover the hospital stay.
Infections and Diseases: Severe infections or diseases that affect the mouth but have systemic health implications might be covered under medical insurance.
Congenital Issues: Birth defects or congenital issues that affect the mouth, teeth, or jaw might be covered by medical insurance, especially if they have broader health implications or require surgical intervention.
Radiation Treatment: Patients undergoing radiation treatment for cancer might experience dental issues as a side effect. Some of the treatments to address these dental problems could be covered under medical insurance.
Certain Tests and Exams: Diagnostic tests, such as biopsies of oral lesions or tumors, might be covered by medical insurance.
Orthodontic Work for Medical Reasons: While orthodontic procedures for cosmetic reasons, such as straightening crooked teeth, are usually covered by dental insurance, medical insurance might cover orthodontic work that’s necessary for medical reasons, such as correcting a cleft palate.
It’s essential to understand that the above examples aren’t guarantees of coverage. Whether a procedure is covered will depend on the specifics of your medical insurance policy and the specifics of your situation. We will work with you and your insurance provider to help you understand how our dental injury treatments are covered. If you’re unsure about a procedure’s coverage, reach out to us for help.
What are my options?
What dental procedures are covered by workers' compensation insurance?
Workers’ compensation insurance provides benefits to employees who suffer work-related injuries or illnesses. Coverage typically includes medical care and a portion of lost wages, among other benefits. Whether dental procedures are covered under workers’ compensation depends on the circumstances surrounding the injury.
If an employee sustains a dental injury as a direct result of their job duties or an accident at the workplace, then the dental procedure to treat that injury would typically be covered under workers’ compensation. Here are some scenarios where dental procedures might be covered:
- Accidents involving machinery or tools that result in damaged or missing teeth.
- Slips, trips, or falls in the workplace causing dental injuries.
- Workplace violence where an employee is injured, leading to dental trauma.
- Injuries sustained in vehicular accidents while performing work-related tasks.
- Other workplace incidents that result in damage to the teeth or mouth.
Examples of potentially covered dental procedures in these situations could include:
- Dental exams related to the injury.
- X-rays.
- Tooth extractions.
- Dental implants.
- Crowns or bridges.
- Root canals.
- Other necessary reconstructive procedures.
It’s essential to note the following:
- Prompt Reporting: If an employee sustains a dental injury at work, it should be reported immediately to their employer.
- Documentation: Keeping detailed records of the injury, including how it happened, any witnesses, and subsequent medical care is crucial. This can help when making a claim.
- Limitations and Exclusions: While workers’ compensation generally covers injuries sustained at work, there could be limitations or exclusions. These might be based on the nature of the injury, whether the employee was adhering to company safety protocols at the time, or other criteria.
To get a clear picture of what’s covered, it’s essential to check the specific workers’ compensation policy or consult with a legal expert familiar with workers’ compensation laws in the relevant jurisdiction. You can also reach out to us for assistance in helping you navigate your work-related dental care coverage.
What are my options?
What dental procedures are covered by auto insurance?
Auto insurance doesn’t primarily cover dental procedures because it’s designed to address the costs associated with vehicle damages, injuries, and liabilities stemming from car accidents. However, under certain circumstances, dental injuries sustained from a car accident might be covered by auto insurance, depending on the policy and the specific coverage in place.
if you’re injured in an auto accident in California and sustain dental injuries as a result, you might be able to claim those dental costs under the medical payments coverage (often called “MedPay”) or under bodily injury liability coverage if someone else was at fault for the accident. Here’s a breakdown:
- Medical Payments Coverage (MedPay): This optional coverage can pay for medical and dental expenses incurred by the policyholder and passengers in their vehicle who are injured during an auto accident, regardless of who is at fault. If you or a passenger suffer dental injuries due to a car accident, MedPay can potentially cover the dental procedure costs.
- Bodily Injury Liability Coverage: If you are injured by another driver who is at fault in the accident, their bodily injury liability coverage could compensate you for your medical and dental expenses, pain and suffering, and lost wages. If your dental injuries resulted from the negligence of another driver, you could file a claim against their insurance for your dental procedure costs.
- Uninsured/Underinsured Motorist Coverage: If you’re injured in an accident caused by a driver who doesn’t have insurance or doesn’t have enough insurance to cover your injuries, including dental injuries, this coverage can step in. It’s an optional coverage in California but can be essential given the circumstances.
It’s essential to read and understand your auto insurance policy or speak with your insurance agent to know precisely what’s covered. If dental injuries result from an auto accident, it’s also a good idea to keep all relevant dental records, bills, and other documentation, as these will be crucial for any insurance claims. Please reach out to us for help with questions regarding dental care covered by auto insurance.
Trusted help for your dental injuries!
If you have recently experienced dental trauma, we can help.
There are many different treatment options for different types of dental trauma, but all rely on quick action. When you receive any kind of dental injury, please contact us as soon as possible. Our team will provide you with instructions on what to do and arrange your treatment appointment.
We have been trusted by Sacramento County residents for over 25 years, and we’ll help you keep your teeth and gums healthy.
Trusted
Experienced, compassionate, trusted doctors available to treat your traumatic dental injuries.
Convenient Locations
We have three locations to serve you. Citrus Heights, Elk Grove, and Sacramento.
Various Insurance Options
Medical Insurance, Dental Insurance, Auto Insurance, or Worker's Comp coverage may cover your treatment.
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