Health Insurance

Is Dental Treatment Covered in Health Insurance?

Nov 24, 2021

Majority of the population in India differ from their visits to a dentist unless the pain is unbearable. The reason for this being that dental care is not much of a priority.  A daily 2-time brushing refers to healthy dental care. Similarly, dental insurance is not much of a priority as compared to other types of insurance coverage. However, dental treatments are a costly affair and the rising cost of medical treatment makes it inevitable to have a dental insurance cover. Read on to understand more about dental insurance and whether or not it is covered under a health insurance policy.

What is dental insurance?

Dental insurance as the name suggests is a type of insurance product designed to provide insurance cover against the cost of medical treatment related to oral healthcare. This insurance plan is designed to cover the cost of dental procedures that are deemed necessary by a dentist or medical practitioner. 

Dental Insurance coverage can be obtained in two ways namely –

  • Stand-Alone Dental Insurance Policy
  • Dental Health insurance cover offered through a health insurance policy

However, in India, there are negligible options for a stand-alone dental insurance policy. OCARE, an independent insurance process as a service platform has launched the 1st group dental insurance product called as OCARE offering a sum insured of INR25,000 with an annual premium of INR 1,699 for its customers. Additionally, the good news is if you want to avail dental insurance, you can avail the health insurance policy route. 

Will a health insurance plan cover dental treatment expenses?

This is a tricky question however on the face of it is generally found that a health insurance policy does not cover dental treatment explicitly under the health insurance policy and if they offer it is subject to restrictions and limits. The exclusive scope of dental treatment cover is still far away from the reality because dental treatments like cosmetic surgery, dentures, dental implants, jaw alignment treatment or surgery, orthodontic surgery, etc. are not covered unless they are a result of an accident or critical illness like cancer.  

What are the ways to cover dental treatment costs?

The dental treatment cost can be covered in the following manner:

  • One of the ways to cover dental treatment cost is through the outpatient department
  • Dental treatment arising out of trauma injury or critical illness like mouth cancer
  • By paying additional premium outpatient dental treatment costs can be covered

List of dental insurance plans offered and included under a health insurance plan in India

Plan Name

Dental Coverage

Bajaj Allianz Health Guard PolicyA comprehensive health insurance plan covers for outpatient treatment arising out of an accident that requires hospitalization
Bharti AXA Smart Health Insurance PlanThe plan covers dental treatment costs of an outpatient dental emergency arising out of an accident only
New India Mediclaim Insurance PolicyA comprehensive health insurance plan covers for outpatient treatment arising out of an accident that requires hospitalization
Ocare Dental InsuranceFirst-ever dental insurance plan offered as a group insurance product. 

What are the inclusions and exclusions of dental insurance?

Although the Indian insurance sector does not provide for a stand-alone dental insurance plan however, some of the leading health insurance providers offer to cover certain dental treatment costs. As per these health insurance policies, the following are some of the inclusions and exclusions:

Inclusion:

  • Oral Check-ups
  • Preventive Treatments
  • Dental x-rays
  • Dental Injury due to accident
  • Clearance exam before chemotherapy

Exclusions:

Most of the health insurance plan excludes the cost of dental treatment arising due to cosmetic surgery, jaw alignment procedure, dentures, dental implants, etc. 

Conclusion

Dental Insurance as a stand-alone health insurance product is way away from reality but for now, you can cover a certain portion of your dental treatment cost through your health insurance policy. So, while selecting the best health insurance plan it is recommended to go through the terms and conditions of the policy to know in detail about the dental treatment cover.

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