Are Deep Cleanings Covered By Dental Insurance? Yes! In Most Cases! But The Antibiotic Rinse Is Not!
If it is Covered at 100%, Why am I Being Charged?
For those of you who have dental insurance and require what is known as a deep cleaning, ask your insurance company if this procedure is covered. It has been my experience that most dental insurance companies consider this to be a benefit. Many cover deep cleanings twice a year at 100%. But prior to getting a deep cleaning, understand that the antibiotic rinse that is recommended by most dentists' offices is NOT covered. That can make a relatively inexpensive or even free procedure quite costly. The rinse is charged for by the quadrant. The charge is typically $70.00 to $80.00 per quadrant. This will then total $280.00 to $320.00 for a service that is covered by your dental policy. If a dental clinic or dental office tells you that you require a deep cleaning more than the insurance company standard of 2 X per year, find a different dentist or get a second opinion.
I recently went for dental work and I know my dental insurance policy thoroughly. I know what is covered before I have something done and what my out of pocket cost should be. When scheduling a deep cleaning, I was told that the cost would be $280.00. I told the dental hygenist that my cost should be zero. She proceeded to tell me that I needed to have an antibiotic rinse during the cleaning. This medication would go down into the bone and kill any infection that there might be and that it is necessary, but that my insurance company would not cover the antibiotic rinse, so I would have to pay for it. I told her that I am on a budget and that if the insurance company would not pay for it then I would opt for the cleaning without the antibiotic rinse. She continued to tell me the benefits of the rinse and I continued to tell her that I didn't want it. Finally, we made the decision that the deep cleaning would be done without the rinse.
Everyone Has to Make a Living
The insurance company does not cover the antibiotic rinse for one reason. Its effectiveness has not been proven. Plain and simple. There is no evidence that conclusively proves that the use of an antibiotic rinse works. Quite simply then, if the insurance company will not pay for this because they believe it to be unnecessary, then I can't be paying for it either.
I understand that the dentist needs to make a living and he or she may sincerely believe that this will help most patients, but I have to be aware of the limits of my own budget.
This is just one procedure that you can save money on by thinking about your options. You may decide that you want an antibiotic rinse and that is fine. My purpose here is to make sure you are informed and to let you know that you have a choice. I will be touching on other ways to help you save money and get the most out of your dental insurance policy in future hubs.
What Is A Deep Cleaning of the Teeth?
Deep cleaning is a method of teeth cleaning used to control or prevent periodontal disease or gum disease. It is also called root planning or root scaling. It combines cleaning above the gum line as well as scraping tartar below the gum line. As stated before, it is almost always covered by insurance.
If you have ever been in the dentist's office, you may remember the dentist looking at each of your teeth and as he does, he recites the tooth number and after that, something else. He will say 3, 4, 5, etc. That is his way of charting bone loss and evidence of how deep the periodontal pockets are. If you hear a lot of 4's or 5's, that is not a good thing! Anything higher than a 3 and chances are you have gum disease. While gum disease cannot be cured once you have it, it can in most instances, be controlled by deep cleanings.
Deep cleanings, sad to say, are many times necessary! They can be uncomfortable, depending on the extent of the disease. If the cleaning is too uncomfortable, it can be done in more than one session, even one quadrant at a time.
If it is painful, ask the hygenist to put more gel on the area. Sometimes that will help dull the pain. They should not be charging any more money for more gel. That is included in the procedure.
Diabetics, or anyone with a chronic disease, are likely to develop gum disease. It comes with the territory. Check with your physician prior to having a deep cleaning. Some patients require pre-treatment with an antibiotic. No matter how many times the dentist tells you it is not necessary, listen to the advice of your medical doctor! They are more equipped to advise you medically.