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Is Sedation Dentistry Covered by Insurance?

September 17, 2023

Filed under: Uncategorized — casper @ 3:55 pm
Young dental patient wearing nitrous oxide mask

Does your child become anxious or afraid at the prospect of visiting the dentist? Do they have medical conditions that make it difficult for them to sit still during treatments? If either of those things are true, you might have thought about asking if your little one is a candidate for sedation. Still, you might wonder how sedation will affect the cost of your child’s care. Is sedation dentistry covered by insurance? Continue reading to discover some important information.

Sedation and Dental Insurance: The Basics

In most cases, sedation is not covered by dental insurance. Many insurance companies classify it as an elective part of treatment rather than a necessity, so they do not help patients cover its cost. This is the case even though it has been repeatedly proven that sedation is highly beneficial for certain groups of patients.

Exceptions to the Rule

Although it is not standard for insurance companies to help with the cost of sedation, there are some circumstances that make it more likely that this service will be covered:

  • Sedation would reduce the total cost of care. This is often the case if a patient needs extensive treatment that would otherwise need to be completed at multiple appointments. Sedation may make it possible for everything to be done at once.
  • A patient has certain medical conditions. Some medical conditions make it difficult or impossible for a child to sit still during dental treatments. Sedation may be the only thing that enables them to undergo necessary care.

It is also worth noting that less expensive forms of sedation, such as nitrous oxide, are more likely to be covered than costlier options, including general anesthesia.

Managing the Cost of Your Child’s Care

Here are some steps you can take to manage the cost of your child’s dental care:

  • Seek preapproval from your insurance company. You should try to find out beforehand whether your insurance will cover your child’s sedation. You should not face any unpleasant surprises when you are paying for their treatment.
  • Ask about payment options. Regardless of whether sedation is covered, you may choose to use CareCredit financing or other provisions to make it easier to fit your child’s procedure into your budget.
  • Assess your child’s potential to undergo procedures without sedation. Some children need sedation to receive treatment, whereas others do just fine with nothing more than local anesthesia. You should know which category your child falls into so you can plan accordingly.

Dental insurance does not usually cover sedation, but there are some exceptions. Communicate closely with your insurance company and dental team so you can navigate the financial aspect of your child’s care.

Meet the Practice

Under the leadership of Dr. Ryne Paulson, Casper Children’s Dental Clinic is proud to provide a broad range of services for young smiles. If your little one struggles with dental anxiety or has other indications for sedation, we would be happy to talk with you about the costs associated with treatment. We can also assist you in filing insurance claims. To learn more about how we may be able to serve your family, contact us at 307-266-1997.

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