Can You Expect Dental Insurance to Cover Sedation Dentistry?

dental insurance form on a table

For patients with dental anxiety, sedation dentistry can make all the difference in the world. It can give them an opportunity to make it dental appointments that would have been impossible for them otherwise, allowing them to completely take charge of their oral health.

As invaluable as it can be for some people, patients often wonder whether they can ever expect their insurance to cover the necessary sedatives for their dental procedure. The answer can be complicated—here’s what you should know.

Is Sedation Dentistry Normally Covered by Insurance?

Typically, sedatives are considered to be a purely elective part of dentistry. Thus, dental insurance companies are usually reticent to pay for them.

As a result, even if the procedure you’re getting is considered to be medically necessary and is covered by insurance, patients are often on their own when it comes to sedation.

Can Sedation Ever Be Covered?

While it’s the sort of thing you probably shouldn’t expect, it is occasionally possible for a dental plan to pay for sedatives in some circumstances. Insurance companies are interested in saving money, so if it becomes clear that sedation will make your procedure cheaper—if it can be completed in fewer appointments, for example—it could be covered.

Sedation could also be covered in the case of severely disabled patients who need it in order to make dental care possible, like those with cerebral palsy, autism, or epilepsy.

Finally, sedation may be paid for in the case of longer procedures, like major oral surgery, where performing the treatment without sedatives is unusual.

What to Do Without Insurance Coverage

Even if your insurance company won’t pay for sedatives, that doesn’t mean that they’re unavailable to the average person. Most dental practices offer alternative options for patients who need additional financial help.

In many cases this comes in the form of financing, typically through third-party financiers like CareCredit. These firms front the cost of care for you then allow you to gradually pay off the balance over the course of several months. This can make dentistry that wouldn’t normally be covered by insurance much more available to patients on a budget. Keep this in mind if you’re someone who thinks that they could benefit from what sedation dentistry could offer you.

About the Author

Dr. Roman Kotlarek believes that there’s a lot that goes in to being a great dentist. He combines the latest techniques and technology with an attention to detail that allows him to take on any problem that his patients could have. Dr. Kotlarek received his degree from the The University of Texas Health and Science Center in San Antonio, and he’s a member of the American Dental Society of Anesthesiology.

If you have any questions about the finances associated with dentistry, he can be reached at his website or by phone at (281) 920-4200.