General Health

What is Dental Insurance and Why Do You Need It?

Most health insurance companies in India do not provide any coverage for dental procedures as they fall under the cosmetic treatment category. However, procedures arising out of accidental injuries are often covered by insurers. With the rising awareness of the need for health insurance among the population nowadays, there is an increase in the number of health insurance policies being sold. With the options and add-ons that insurers offer, individuals can opt to increase their cover as they grow older or based on their health requirements.

What is Dental Insurance?

Dental insurance refers to the cover provided for dental procedures (not including cosmetic dentistry) that are deemed necessary by a medical professional. Procedures would be classified under either preventive or diagnostic. A few of the procedures that are covered under dental insurance include filling of caries, tooth extractions, dentures, root canal procedures, etc.

Like healthcare, dental care can also be quite expensive in India, given the skills and the specialised setup needed along with the impact of inflation. The cost of dental care also depends on the type of treatment you undergo, the number of sitting each procedure takes, etc. However, to cover these expenses, you can always choose a health insurance plan that also includes a dental insurance cover, so that you need not spend money out of your own pocket for these dental procedures.

It is important to understand that dental insurance only covers dental treatment related to accidents, injuries, illnesses, or as recommended by a dental healthcare professional. Hence the procedures can either be identified as preventive or diagnostic and do not include cosmetic surgery. Moreover, cosmetic surgery is extremely specialised and the cost for those procedures is too high and so, they cannot be covered under general health insurance plans.

Why Do You Need Dental Health Insurance?

Just like healthcare, dental care is also becoming expensive with the time. Even the simplest dental procedures such as tooth-fillings can be quite costly while other major procedures can majorly affect your savings.

These are a few reasons why dental healthcare can be quite costly:

  1. Inflation
  2. Specialised lab setup
  3. Professional skills
  4. Consumables for treatment

OPD dental treatment offers a coverage of up to ₹10,000 for the cost of tooth extractions, root canals and filling, subject to you availing yourself of the dental health insurance plan for two consecutive years. To ensure that you do not have to dip into your savings or cut down on your essential expenses for

Dental treatments, it is recommended that you opt for a dental health insurance plan. While many health insurance policies in India offer dental cover, it is important to choose a health policy whose dental plan offers the coverage, benefits and features you need.

Dental Insurance Coverage in India:

In India, there are very few insurance providers who cover dental procedures, with none of the major insurance companies offering dental insurance as an exclusive cover. More often than not, dental treatments are covered in the event of an accident and would be limited to repairing the damage caused by such. An example of such coverage is the Bharti AXA Smart Health Insurance Plan, which covers dental treatment up to a maximum of Rs.5,000.

OCare, an insurance Process as a Service (PAAS) platform has recently launched India’s first dental insurance plan. The plan provides insurance up to Rs.25,000 a year per person and covers pre-existing dental conditions as well. Additionally, the plan provides two dental check-ups a year as well as a loyalty card that is redeemable on dental services. With a view to making dental treatment accessible and affordable for all, OCare’s dental insurance plan is being launched in villages through the respective Gram Panchayats. In this way, it is hoped that individuals across India will have access to quality dental care without having to worry about the cost.

Another way insurers cover dental treatment is through out-patient department (OPD) treatments. Insurance companies that offer dental insurance for dental procedures up to a maximum limit as specified in the policy document only, irrespective of the dental procedure opted for. Additional terms govern this kind of coverage, however, further limiting their scope. This includes claims pay-outs for dental procedures after the second policy year only, among others.

In the case of OPD treatment policies, policyholders will have to pay an additional premium, which is often very high. Thus, while some inroads are being made in providing dental insurance, comprehensive dental coverage is still not a reality in India. GST rate of 18% is applicable for all financial services effective July 1, 2017. Premiums may vary depending upon factors like age, location, and prevailing taxes/GST.

Benefits of Dental Health Insurance Plans in India

  1. Dental insurance plans cover all oral treatments, including surgery.
  2. Several dental insurances cover medical check-ups.
  3. Some plans also provide a free consultation to the patient.
  4. Dental insurance plans partially cover teeth capping, root canal, and teeth whitening treatments.

Some of the insurance companies provide discounts on prime treatments like implants and bracing along with assured benefits in some of their policies.

Inclusions and Exclusions Under Dental Health Insurance Policies

Inclusions

  • Root Canal Procedures
  • Tooth Extraction
  • Infections and Oral Cyst
  • Tooth Filling
  • Follow-up treatment
  • Dental Surgeries
  • Gum Diseases Treatment
  • Dental Implants
  • Dental X-rays
  • Regular Oral Health Check-ups and Preventive Treatments

Exclusions

  • Dentures
  • Cosmetic treatments
  • Jaw alignment etc.

To choose the right insurance company for dental insurance, you need to:-

  1. Know the coverage and limitations under the plan.
  2. Compare the benefits offered and the cost involved to make a wise decision
  3. Opt for an insurance provider which covers major dental treatments under a health insurance policy.

The best way to get dental insurance benefits is by selecting a plan with dental care benefits as a permanent inclusion or as an add-on benefit.

Source:

1.      https://www.bankbazaar.com/health-insurance/dental-insurance-india.html

2.      https://iiflinsurance.com/knowledge-centre/health-insurance/how-to-buy-the-best-dental-insurance-plans-online-in-india

Author

Dr Shilpa Subramanian

Dr. Shilpa Subramanian is a MDS, Periodontist and currently manages Global Pharmacovigilance and Medical Affairs Operations at a Healthcare company in Mumbai. She is passionate about staying ahead of the curve in clinical and non-clinical advances in the field of pharma and healthcare

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