When you’re raising a child, many things that should be straightforward can become complex. Just leaving the house can take a long time and a lot of effort! However, especially if you have a child with anxiety or special needs, simple tasks like going to the dentist or getting necessary dental work done can feel overwhelming. Fortunately, sedation dentistry can make their visits less stressful and more successful! But will insurance pay for it?
Does Insurance Cover Sedation Dentistry for Kids?
As simple as this question may seem, the answer can be complicated. It depends on three important factors: the type of sedation your child receives, whether sedation is deemed necessary, and which type of insurance you’re filing the claim through.
Type of Sedation
Although there are several types of sedation medications used for dental procedures, two of the most common opposite ends of the spectrum are nitrous oxide and general anesthesia. As the mildest form, nitrous oxide is gentle enough to be used on children, but it generally tends not to be covered. In contrast, general anesthesia, which puts the patient to sleep and requires the expertise of an anesthesiologist, usually is covered by insurance.
Need Vs. Optional Luxury
Insurance companies, both medical and dental, do not pay for services that they consider elective or optional. In some cases, dental sedation isn’t required, but rather something that makes the visit easier. As a result, insurance will not pay for sedation. In other situations, such as for a child with special needs, sedation is more than a luxury but a necessary part of their care, which means insurance will contribute to the cost.
Type of Insurance
If you have dental insurance, chances are that you also have medical insurance. Largely, these are kept separate, with one important exception. If general anesthesia is needed for a child’s dental procedure in a hospital setting, medical insurance will kick in. For any anesthesia or sedation administered in a pediatric dental office, only dental insurance will apply.
If Insurance Doesn’t Cover Sedation, Then What?
In many situations, dental and medical insurance plans will not pay the cost of having sedation for your child’s dental work. However, you have other options for making this treatment affordable. You can pay over the course of several months instead of all at once through CareCredit, a highly trusted financing company. Through this payment plan, you can more easily include a smaller monthly amount into your budget.
Although life is full of complicated situations, you aren’t alone in figuring it out! Your child’s pediatric dental team can help you interpret complex insurance coverage and help you take full advantage of benefits you’re entitled to for your child’s care.
About the Practice
At Wash Park Pediatric Dentistry, Dr. Patrick Bowman and Dr. Samantha Graffeo offer nitrous oxide sedation as well as general anesthesia for children who need help managing anxiety or other needs. For general anesthesia, we work with board-certified anesthesiologists both in our office and in a hospital setting, based on the patient’s needs. If you and your child would like to use sedation dentistry at their next visit, contact our team online or call 720-647-6310.