top of page
  • Writer's pictureAhsan Malyk

Does Medical Insurance Cover Root Canal?

Root canal treatment was falsely presented as a kind of culmination of suffering. The truth is that a simple root canal treatment is nothing more than a filling. The dentist cleans the inside of the infected tooth and seals it to prevent reinfection. Voila! Your teeth are healthy again.

Does my dental insurance cover root canal treatment? The average cost of root canal treatment

Root canal costs range from $600 to $1400. The front teeth are smaller and more accessible, making repairs less expensive. Here are the average prices by tooth type:

  • incisor:

  • $850

  • Premolars/premolars:

  • $950

  • Molar:

  • $1200

These prices vary depending on the type of existing tooth damage.

A dentist may not be able to perform the procedure. Endodontics is the branch of dentistry that deals with the soft tissue inside the tooth known as the "pulp". Only 3% of dentists are trained endodontists who can perform root canals. An endodontist should be consulted for a more accurate estimate of the root canal, especially if more extensive surgery is required.

What does my dental insurance cover?

Supplemental dental insurance tends to have less coverage than standard health insurance. If your insurance covers root canals, root canals may not be fully covered by your plan. You may have to pay for the entire procedure yourself. It depends on your coverage.

If you're feeling overwhelmed trying to figure out your health insurance plan, you're in the same boat as millions of Americans. Health insurance plans can be incredibly detailed and intimidating.

Here are some tips to help you figure it all out.

Your front office staff is your best resource

Some of the best people to demystify your dental insurance are the staff who greet you at your dental office. An office manager is the best person to turn to for help, but any employee with an endless client folder can probably help you with insurance questions.

These intrepid employees have to deal with statements with health insurance companies on a daily basis and often know more about supplemental dental insurance than root canal dentists.

Dental insurance is consolidated through a few large companies such as Delta Dental, Cigna and UnitedHealthOne. Reception staff are familiar with everyone. It is very likely that they will be familiar with your particular compensation plan and your particular root canal treatment.

These friendly staff often get in touch with each of these dental plans and can call you directly to clarify your coverage. You can get rid of the headaches that can arise when trying to navigate your insurance company’s automated directory.

Understanding dental insurance

If you dare to interpret your dental insurance for yourself, your insurance record will usually list root canal treatment as a specific procedure. If you download the PDF version of the dental plan, you can directly search for the term root canal treatment.

All of the following conditions can affect how much you pay for out-of-pocket root canal treatment.


Refers to out-of-pocket costs before insurance covers dental care

This applies to the cumulative cost of dental services from the beginning of the year

This May does not apply to all services (e.g. regular checkups)

The deductible will be deducted from dental services received since the beginning of the year. If you paid part of your copay at the beginning of the year, you may have already paid all or part of your deductible. maximum

The total amount of dental benefits paid by an insurance company in a given year

If you have a significant amount of dental work in a given year, you should consider

Waiting period

Root canal treatment may not be covered until monthly premiums are paid for a certain period of time (insurance companies don't want you to purchase insurance just for root canal treatment).

Note: A tooth that needs root canal treatment can continue to deteriorate if you wait months to get it done.

Mutual aid/partial co-payment

This is the percentage of the root canal cost under insurance that the insurance company pays.

  • After paying the annual deductible

  • if the annual cap is not exceeded, and

  • Those who are not currently undergoing root canal treatment Waiting period (in that case, not eligible for compensation)

Root canal

Removing nerves, blood vessels, and other living tissue from inside a tooth does not fall under the medical category, so health insurance is unlikely to cover root canals.

However, if the pulp is infected or has progressed to the abyss (pockets of bacterial pus), the root canalist is likely to treat the tooth and may prescribe antibiotics. Your health insurance may cover the antibiotic bill needed after root canal treatment to prevent the infection from spreading to other parts of your body.

Tori Removal

Your insurance company probably won't cover the cost of a torus (palatal or mandibular annulus) removal because it is rarely medically necessary to remove extra bone from the maxilla or mandible.

You may need to pay your oral surgeon out of pocket or bill your dental plan. Birds are benign tumors that do not cause pain or other medical problems if left untreated.

dental implant

Your health insurance may pay for medically necessary dental implants that are appropriate for the evaluation and treatment of any disease, condition, illness, or injury and that meet applicable standards of care.

For example, covered implants may include replacement of teeth lost due to an accident or disease.

  • Dislocated tooth after accidental non-occlusal injury

  • Tooth extraction before radiation for cancer treatment

Orthodontic device

Health insurance may pay for the cost of medically necessary orthodontics if braces prevent, diagnose, or treat an injury, illness, or condition.

The definition of included braces may vary depending on the age of the person being treated and the stage of the procedure.

  • Children: For the treatment of congenital malformations such as cleft lip and cleft palate

  • Adult: Treat conditions such as temporomandibular joints and sleep apnea

  • Distance: before radiation and chemotherapy

Dentistry Covered by partial medical care

Your mouth and teeth are important parts of your body, but health insurance doesn't cover most dental treatments. However, some dental treatments are medically necessary.

5 views0 comments


Post: Blog2_Post
bottom of page