Is there dental insurance in India? Is dental treatment covered by insurance? This article will help you know all about dental insurance.

A warm smile and beautiful, healthy teeth bring great confidence in one’s personality. Dental insurance can help you get this confidence through regular dental cleanings, preventive care and protection from unexpected accidental injuries to teeth and gums.

People are purchasing health insurance policies to avoid huge medical expenses that will burn out their pockets. Health insurance covers several critical illnesses in their plan, however, when it comes to dental insurance it is often neglected. Surprising statistics show that 85% to 90% of Indians are suffering from dental issues. Due to poor oral hygiene, tobacco use, and a sugary diet, most Indians suffer from oral cancer, cavities, and periodontal diseases.

Nobody likes going to the dentist. Sometimes the bill can be even more unpleasant than the procedure itself. Dental Filling costs around Rs. 6500, teeth alignment can cost up to Rs. 55,000 to Rs. 1.5 lakh and root canal treatment can cost around INR 3000 – 6000.

What Is Dental Insurance and How Does It Work?

Dental insurance comes under health insurance that covers your necessary dental treatment costs. The health insurance plans offer dental insurance as a part of their plan which helps the policyholders cover the expenses related to the dental procedure, hospitalisation and medicines. The Insurance Regulatory and Development Authority of India (IRDAI) have announced that dental treatments should also be a part of health insurance even if the procedure does not require hospitalisation. We do not have any stand-alone dental insurance in India so it comes as a part of health insurance.

Dental insurance in India can be availed in three ways;

  1. In case of accidental injury, dental treatment is available as part of the normal health insurance, but the treatment is limited only to restore the normal dental functions and realignment of teeth.
  2. Some insurance companies provide dental insurance as a part of Out Patient Department (OPD). Certain high-end policies have a higher premium amount which provides limited OPD cover of up to Rs. 5000 to Rs. 10,000. This limited OPD cover provides basic dental treatments like filling, tooth extraction, root canal, etc. These policies cover dental as an OPD procedure.
  3. Another case where dental insurance is covered is under group health insurance policies. Group health insurance policy is generally purchased by companies for their employees which do cover dental treatment. Depending on the cover opted by the corporate the health insurance might include dental insurance.

Need for Dental Insurance:

  • The dental treatment costs are quite expensive due to advanced lab features and medical advancements, so dental insurance will help you financially at the time of need.
  • Almost 85% of the population are facing dental issues due to poor oral hygiene,  junk food diets and excessive use of tobacco products. Having dental insurance will ensure our overall oral health care.
  • Having dental insurance will encourage us to get regular dental check-ups and take preventive treatments.

Benefits:

  • Visiting a dentist at least once a year is highly recommended by health experts. Since the dental insurance covers primitive care it will encourage us to get regular dental check-ups.
  • Few plans even offer a free consultation.
  • They cover dental care treatment including surgeries and critical illness.
  • Some insurance companies offer discounts for dental treatments like bracing and dental implants.
  • It will waive off the burden of the treatment cost.
  • Dental insurance comes as a part of a health insurance plan that covers necessary expenses that occur due to dental procedures like diagnostic, preventive or curative treatments.

Health Insurance Plans That Cover Dental Insurance:

The health insurance plans that cover dental insurance are discussed below.       

  1. Family Floater Mediclaim Policy:

Since this policy benefits can be reaped by the entire family members, it also covers dental care treatment which depends on the type of policy chosen.

  • Individual Mediclaim Policy:

This plan may cover dental treatments and procedures depending upon the plan you choose. In most cases, only dental treatment due to accidental injuries is covered. Most of the plans cover them as additional benefits for which you have to pay an extra premium.

  • Preventive healthcare Insurance policy:

This plan covers preventive care such as doctor consultation, medical check-ups, etc. Hence it also covers some dental procedures under the plan.

  • Critical Illness Insurance Policy:

Since this plan covers a specified critical illness most of the plans cover surgeries related to oral health care.

  • Medical Travel Insurance:

The travel insurance plans cover emergency dental treatments required in case of accidental injury. But only a limited amount will be compensated according to the policy.

  • Personal Accident Policy:

Almost all the plan in this policy covers the expenses for dental treatment in case of accidental injury.

Best Dental Insurance Plans Offered by Companies:

Below mentioned is a list of health insurance plans that provide dental insurance.

1. HDFC Ergo Easy Health Plan:

  • This plan in HDFC provides dental insurance as additional benefits.
  • It covers outpatient dental cover.
  • This plan allows dental treatment after a waiting period of 3 years.
  • Dental coverage offered is up to 1% of the sum insured amount.

2. TATA AIG Medicare Premier Plan:

  • This plan provides in-patient dental treatment.
  • OPD dental treatment can be availed.
  • The OPD dental treatment covers RCT, tooth filling, tooth extraction, etc.

3. Digit Healthcare Plus Plan:

  • This plan provides dental insurance as additional benefits.
  • It covers outpatient dental treatment.
  • The covers dental treatment like X-rays, filling, tooth extraction, relief from dental pain, root canal treatment, teeth alignment, etc.
  • Certain procedures like cosmetic surgery, dentures, dental implant, etc are not covered.

4. Manipal Cigna- ProHealth Accumulate:

  • This plan covers dental insurance.
  • It offers coverage up to Rs.5000, Rs. 10000, Rs. 15000 or Rs. 20000 based on the sum insured amount.

5. Apollo Munich Maxima Health:

  • This health insurance plan provides outpatient dental treatment coverage.
  • This plan covers dental treatment like X-rays, root canal, filling, tooth extraction, and prescribed medication.
  • This dental insurance benefit can be availed only if the policyholder completes 3 policy years.
  • Cosmetic treatment is not included.
  • It offers limited coverage only to a specified amount based on the sum insured.

6. Bajaj Allianz Health Guard Policy:

  • This is a health insurance plan that provides dental insurance.
  • This policy covers dental treatment and procedures that require hospitalisation but dental treatments that do not require hospitalisation is not covered in the policy.
  • It covers expenses for dental treatment like surgery, crowns, extraction, and filling.

7. ICICI Prudential Health Saver:

  • This is a type of comprehensive health insurance plan.
  • They offer benefits for dental care expenses.
  • To avail of this benefit, a minimum of 3 policy years has to be completed by the policyholder.

8. Bharathi AXA Smart Health Insurance Plan:

  • This healthcare plan covers dental insurance.
  • This plan provides dental treatment only in case of an accidental injury.

9. Birla Sun Life Saral Health Plan:

  • This is a type of unit-linked plan that offers reimbursement benefits for dental care expenses.

10. Cholamandalam Chola  Health Plan:

  • This is a comprehensive health plan which covers dental treatment expenses.
  • This feature can be availed as an add on benefit by paying an additional premium.
  • The coverage expense for dental treatment is limited up to Rs. 10,000 in every two years.

11. Aditya Birla- Activ Health Platinum Enhanced:

  • This plan provides dental insurance for policyholders in the Platinum variant.
  • The sum insured for the platinum variant is a minimum of Rs. 2 lakh.

12. Star Health Insurance Policy:

  • This plan covers outpatient dental treatment expenses up to Rs. 5000 or Rs. 10000 once after 3 years.

13. LIC Health Protection Plus:

  • This plan covers all dental expenses.

Dental Procedures Covered in Dental Insurance:

The dental procedures that are generally covered under a health insurance policy are;

  • Tooth filling
  • Dental X-rays
  • Root canal
  • Routine examinations for dental care
  • Follow-up treatments
  • Medicine bills
  • Hearing aids
  • Tooth extraction
  • Oral cyst and infections
  • Tongue-tie
  • Dental injury caused due to accident
  • Dental implants
  • Dental surgeries
  • Treatment for gum related disease
  • Regular oral check-ups and preventive treatments

Dental Treatments That Are Not Covered:

The following dental treatments are excluded from the dental insurance plans.

  • Cosmetic treatments
  • Dentures
  • Jaw alignment
  • Dental prosthesis
  • Orthodontic surgeries

How to File a Claim for Dental Insurance?

  1. For a Cashless Facility:
  2. You need to avail treatment from the network hospital.
  3. Inform the insurer in advance at least 2 days before the treatment and get approval for a cashless facility.
  4. Keep your e-health card and necessary documents in hand to initiate the claim process in the hospital.
  5. Fill the cashless request form in the hospital. If the documents are proper your claim will be processed for a cashless facility.
  6. Once you get the approval from the insurance company the hospital will send the treatment papers and documents to the insurer. Then the insurance company will settle the medical bills directly to the hospital.
  7. For Reimbursement:
  8. If you avail of treatment in a non-network hospital the treatment cost will be reimbursed by the insurer. Just submit the necessary documents and treatment papers to the insurer and place a reimbursement claim request.

Documents Required to File a Claim for Dental Insurance:

  • Personal identity proof – Passport, Aadhar card, Pan card, Voter ID etc.
  • Address Proof – Passport, driving license, Electric bill, telephone bill, etc.
  • Age proof – Birth Certificate, SSLC mark sheet, Voter ID.
  • Passport size photo
  • Discharge summary
  • Properly filled Claim form
  • KYC documents
  • Policy documents
  • Pharmacy bills
  • Hospital bills
  • Treatment papers
  • Consultation bills

Advantages of Getting Dental Insurance:

  • It will help keep your dental treatment expenses at bay.
  • It will encourage you and your family to maintain dental health.
  • You will get the benefits of regular health insurance plans plus benefits of OPD expenses that cover dental treatments.

Key Points to Choose the Right Cover:

To get the best dental insurance plan certain key points have to be followed.

  1. Choose a health insurance plan that covers major dental procedures.
  2. Most health insurance plans offer dental health care as an additional benefit by paying an extra premium.
  3. Read the policy documents carefully and know the benefits and limitations of the plan.
  4. Check out the network hospital list for a dentist near your location.
  5. Make a wise decision by comparing the cost and benefits of various plans available in the market.
  6. Choose a plan according to individual requirements.

How to Improve Dental Hygiene?

Let us discuss some important points to keep your teeth and gums healthy as it is rightly said: “Prevention is Better than Cure”.

  • The first thing would be brushing your teeth twice daily which we all have been hearing since our childhood.
  • Flossing your teeth will prevent the formation of dental plaques.
  • Health experts highly recommend we visit our dentist at least once or twice a year and get dental check-ups done.
  • Avoid eating too much sugary diet.
  • Avoid smoking and usage of tobacco products as it not only damages your lungs but also causes some life-threatening diseases like oral cancer.
  • Drinking lots of water and gargling with saltwater in the morning also prevents bad breath and tooth decay.

To Sum Up!

To get the best dental insurance plan it is important to choose the right plan that covers dental health care or it can be availed as an add-on benefit by paying an extra premium. Just as health care is important dental care is also very important. Getting dental insurance not only improves your oral hygiene but also saves you from expensive treatments. A small investment will help you go a long way with a healthy smile.

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Prateek Mahesh

Prateek has 17+ years of experience writing in Investment Strategy and Sales for Life Insurance. He has done MBA in Insurance and Investment.

Their aim is to educate people on various insurance topics so that they can make wise decisions.

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