Is sedation dentistry covered by insurance?

People interested in sedation dentistry in Raleigh, NC often ask us that question. Unfortunately, most dental insurance plans do not cover the cost of sedation.

This is somewhat frustrating from my standpoint. There are many people going without needed dental care – from regular exams and cleaning to more serious issues – because of the anxiety they feel about going to a dentist. Those people often wait until the condition becomes serious. At that time, they require much more costly procedures that ARE typically covered by dental insurance.

It’s too bad there’s not an easy way to track what’s happening with these would-be sedation dentistry patients. It’s my guess that accurate comparison data – contrasting costs of early treatment (including sedation costs) versus outlay for treating the more advanced situation – would show that covering sedation dentistry costs could reduce payouts for insurance companies in the long run. Crowns and bridges can be quite expensive in contrast to filling teeth that have small cracks or show small areas of decay.

With time, I hope that dental insurance providers will figure this out. For now, I think patients must do their own financial evaluations. Even without insurance reimbursement for the sedation dentistry costs, it is possible that patients could reduce their out-of-pocket costs in the long run. The later you treat a dental issue, the more expensive it’s likely to be. I don’t advocate using sedation for everyone – only those who need it.

I’m hoping that sedation dentistry will soon be recognized as a (reimbursable) service critical to preventive dentistry for many patients. Until that day comes, our office can work with you to establish a payment plan for sedation dentistry in Raleigh, NC to help you get the treatment you need.