If you have chronic tooth pain, there could be a number of reasons why. Some of the top causes of oral health problems are things like cavities, dental abscesses, cracked teeth, or TMJ disorder. Depending on yours, your dental insurance plan may help to cover part of fixing the problem.
Step 1: Find the Cause
You’ll need to schedule an oral health assessment or dental exam to get a full diagnosis of what’s going on inside of your mouth. This visit will include things like:
- An exam
- A series of comprehensive or tooth-specific X-rays to evaluate one or two teeth
- Screening for gum disease
- Bite analysis
- Evaluation of your existing dental work
- An oral cancer screening
Once your dentist has all of the information available, he or she can make a formal diagnosis as to the root cause of your tooth pain. In most cases, you’ll want to treat it as soon as possible. Delaying dental care almost always results in more extensive and expensive treatment needs.
The great news is that your dental insurance will usually cover the cost of your exam and X-rays. While there are some restrictions (such as how frequently certain types of radiographs can be taken,) if you haven’t been to the dentist in a while and need to get a checkup, it will likely be covered at or close to 100%. You may want to call your dentist — or the one you plan on going to — first, to make sure that they accept your specific type of dental insurance plan.
Step 2: Planning the Treatment
After you finally know what’s going on with your teeth, your dentist can create a customized care plan that breaks down the various procedures, appointments, and prices involved in fixing the problem. At this point, you’ll be able to find out if your dental work is covered by your insurance.
The treatment coordinators will use your insurance card to verify benefits that you’re entitled to under your plan. For instance, your fillings might be covered by your policy, but it may pay more for metal ones than for the white (non-mercury) restorations. After the document is prepared, you’ll be able to see what your estimated out-of-pocket costs are.
That’s right, there will usually be a leftover amount that your dental insurance doesn’t cover. Since insurance is “prevention focused,” it usually pays more for cleanings and exams, but less for fillings, crowns, root canals, or dental emergencies.
If your dental insurance doesn’t cover a particular procedure, ask if any other alternatives are available. Maybe your plan won’t pay for a root canal, but it will an emergency extraction. Although this can provide you with fast pain relief, you’ll need to make plans to replace the tooth in the near future so that other teeth don’t start to move out of place. Keep these details in mind before choosing something that has lasting effects on your entire smile.
Waiting too long to plan your treatment could result in a dental emergency when you least expect it. Once that happens, your tooth pain won’t be something that’s a minor annoyance; it can prevent you from going about your normal daily activities or even send you to the hospital.
Step 3: Scheduling and Paying for Treatment
After you’ve determined whether or not your dental insurance covers the treatment that you need, it’s up to you to schedule the procedure and pay for any leftover balance. Keep in mind, there’s always the chance that your claim is rejected and you’re left having to pay for the balance that’s denied by your insurance company. When this happens, you may want to ask your dentist if they have an option like a payment plan.
An affordable alternative to dental insurance is a Cigna discount dental plan. These savings programs offer 15-50% off of set procedures, so that you never have to be caught off guard about how much you’re paying for. It’s not insurance, but it’s similar. Rather than processing claims and waiting to be reimbursed, Cigna savings plan members take advantage of the cost savings right at the dentist’s office.
Unlike insurance plans, Cigna dental savings programs don’t have any type of an annual maximum, so you can use your discount as much (or as little) as you like. If your dental insurance only covers the cost of four fillings or two crowns, but you need more than that, a discount membership will help you affordably pay for all of the treatment you need…instead of putting it off until your insurance benefits reset (and hoping things don’t get worse.)