Health Insurance for Dental Treatments

India's Dental Insurance: Comprehensive Coverage Guide

It is a well-known fact that oral health is important for our overall health, well-being and quality of life. Dental hygiene is directly associated with the health of other body organs and also directly linked to diseases like diabetes, stomach ulcers etc. Hence, it’s important to visit the dentist to ensure that you are in the pink of your oral health. Maintaining good dental health will also help us enjoy good food and moreover, a good set of teeth will help us smile always.

The expenses associated with dental treatments and dental insurance are often ignored by people which  leads to out-of-pocket expenditures. According to WHO, in the year 2020, Indians spent 62.7 per cent of their total health spending as out of pocket expenses, which is why a good dental insurance in India is the key to secure the best coverage policies.

When it comes to health insurance, one of the most common questions people have is whether full coverage dental insurance is available under OPD. The answer may vary depending on several factors, including your dental insurance plans, the insurance provider, and your policy's specific terms and conditions.

Generally, dental insurance India plans are considered outpatient department treatments (OPD) in a hospital or clinic.

What is dental insurance in India?

Dental health insurance is a health insurance benefit or a base cover or an add-on offered under a plan that can cover dental treatment expenses and related medical procedures, such as, OPD consultations and dental surgeries.

Why should you buy dental insurance?

Dental insurance plans in India are not available as standalone policies these days. Most of the time, it is covered as a part of a policy where the insured can claim the dental expenses along with the other reimbursement medical expenses. 

Since dental treatments are expensive due to the usage of innovative techniques and methods, it is advisable to purchase a health insurance policy that offers dental insurance as an add-on benefit.

Types of Health Insurance Plans Offering Dental Insurance in India

1. INDIVIDUAL DENTAL INSURANCE

Individual Dental insurance plans are tailored to the needs of individuals, covering dental expenses, which includes emergency dental procedures and routine surgeries.

2. CRITICAL ILLNESS PLANS

These standalone plans may cover dental surgeries as the medical expenses incurred on the critical illness procedure and treatment is covered. 

3. FAMILY FLOATER PLANS'

This health insurance plan covers the dental expenses of the entire family, if mentioned in the policy clause.

4. OUTPATIENT HEALTH PLANS

It covers outpatient medical expenses of the policyholder, which includes diagnostic tests, dental OPD consultations, and medicines.

5. PERSONAL ACCIDENT PLANS

At times, a personal accident plan covers dental expenses that results on the occurrence of an accident or injury.

What is OPD?

OPD, or Out-Patient department, is a section of a hospital or clinic that provides medical care to patients who do not require admission. In other words, OPD services are meant for patients who visit the hospital or clinic for consultations, diagnosis, treatment or other medical services without being admitted to the hospital.

How are dental insurance and dental treatments connected with OPD?

OPD is defined as the Outpatient Department in a hospital and covers the expenses such as the insured’s visit to a doctor’s clinic for illness, the consultation fees and for many other services like getting an injection, dressing of wound etc, provided by a physician at the clinic or a diagnostic centre. Similarly, it can cover expenses for medicines at the pharmacy, diagnostic tests like X-rays, Blood tests etc, at the laboratory and for minor procedures for which you don’t have to get admitted to a hospital.

Some health insurance providers may also offer the best dental insurance/coverage as a part of their comprehensive policy. These plans may cover expenses related to hospitalisation, including dental procedures performed during hospitalisation.

Is Dental Covered in Health Insurance plans?

Dental treatment coverage under health insurance plans still needs to be more common in India. However, some health insurance providers do offer dental treatment coverage as an add-on or a rider to their health insurance plans. Dental treatment coverage may include expenses related to dental consultations, diagnostic tests, dental procedures and dental surgeries.

It is important to note that dental treatment coverage may have specific terms and conditions that vary between insurance providers. Some dental health insurance plans may cover basic procedures, while others may cover more complex procedures like root canal treatment. Some insurance providers may also have a waiting period before the dental treatment coverage becomes effective.

While dental treatment coverage under OPD is rare in India, some insurance providers do offer affordable dental insurance plans that cover a range of dental treatments. These plans may cover expenses related to regular dental check-ups, cleanings, fillings, extractions, root canal treatment, orthodontic treatment and more.

When choosing a health insurance plan that includes dental coverage, it is essential to carefully review the terms and conditions of the plan to ensure that it provides the coverage you need. Some plans may have specific exclusions or limitations related to dental treatments. It is also essential to review the network of dental providers covered under the plan to ensure you can access quality dental care.

Dental Insurance Process in India

Dental insurance coverage is usually not a process of a basic health insurance policy. It can be covered as a OPD cover by paying additional premiums.

It comes with the following conditions:

• Waiting period - The policyholder has to serve a waiting period to raise a claim against your dental insurance cover.
• Upper limit - The dental cover comes with a certain monetary limit with specific conditions and terms as per the policy clause.

Star Health Insurance provides the Best Dental Insurance in India

Star Out Patient Care Insurance Policy (UIN : SHAHLIP22231V012122) is designed to offer coverage especially for OP consultations, non-allopathic treatment expenses, diagnostics, physiotherapy, dental, ophthalmic treatment expenses, pharmacy expenses and more. 

Star Outpatient Care Insurance Policy offers three different plans with varied benefits: Silver Plan, Gold Plan and Platinum Plan. The policy holder can also avail of the benefits of discounts on premium up to 25% after 2 continuous claim-free years on this policy only with Star Health Insurance.

With Star Comprehensive insurance policy (UIN: SHAHLIP25037V082425), the insured can avail of coverage for dental treatments under OPD expenses as per the policy clause.

 Reasons to purchase dental health insurance

• Save on dental treatments

Dental care could easily become a twice-a-year affair for a teeth-cleaning, or it could be thousands of rupees in oral surgery bills. Dental problems can start at the drop of a hat–whether you take extra care to floss every day, or not–so the best way to prevent your finances from suffering is to have a health insurance policy that provides coverage for your dentist visits.

• Maintain dental health

The best way to prevent oneself from spending money on dental bills (besides getting dental health coverage), is to take necessary routine care of the mouth’s overall health. By doing regular teeth cleanings and check-ups one can ensure that their health is tracked by a professional.

• Peace of mind

Besides its benefit of cost savings and good dental hygiene, dental health insurance gives you peace of mind as you keep your savings intact and know that your smile is protected. Your insurance will have your back If anything were to happen to your teeth. The benefits of dental health insurance are many in terms of saving your out-of-pocket expenses which cannot be ignored.

Benefits of Dental Health Insurance Plans 

It is best to go for a medical insurance plan that covers dental insurance coverage in India, since people will not get an option to buy a standalone dental health insurance plan. 

Here are some of the benefits of getting a dental insurance in India:

• Coverage for complete dental treatments

Opting for a dental surgery insurance will help you save money in the long run and reduce out-of-the-pocket expenses as you will get covered with the OPD dental consultations and in-patient hospitalisation costs.

• Cashless facilities

A dental health insurance plan helps you claim cashless treatment at network hospitals for planned hospitalisations and emergencies. 

• Benefits on Consumables

Consumables used during hospitalisation for treatment or surgical purposes of accidents, illnesses, or injuries are covered under a dental insurance plan. 

• Preventative Health Checkups

Along with OPD dental treatments and in-patient hospitalisation, you get dental examinations during your preventative health checkups. You can find out any oral issues in the initial stages itself. 

• Tax Benefits

Under the Section 80D of the Income Tax Act, one can claim maximum deductions on health premiums annually. Also, please consult with your tax advisor and have a look at the act for the tax details.

What are the inclusions under a dental insurance plan?

Dental health insurance cover basic procedures, preventive care, and major treatments. It can include cleanings, regular check-ups, root canals, and orthodontics. Here is the list of common inclusions in a dental insurance policy:

• Fillings and extractions
• Dental injury due to accidents
• X-rays
• Preventive health check-ups
• Oral check-ups, and more.

Things to remember while buying a dental insurance

It is essential to have a right insurance coverage in place, when it comes to taking care of your dental health. Here are a few things to remember while buying a dental insurance plan:

• Look out for the plan’s coverage that extends for vast dental procedures and treatments.
• Find out the dental insurance plans that suits your needs better.
• Read the policy document and check the inclusions and exclusions.
• Use the network hospital locator to check the network hospital addresses near your residence.
• Check the efficiency and reliability of the insurer to settle your claims quickly.

Documents required for dental claim settlement

• Active dental insurance policy
• Policy card
• Clinic/hospital bills
• Claims form (usually for the offline process)
• Identification card, eg: Aadhar card

FINAL THOUGHTS 

Dental treatment coverage under OPD in health insurance plans in India is still not very common. However, some insurance providers do offer dental treatment coverage as an add-on or a rider to their health insurance plans. 

Suppose you are looking for a health insurance plan that covers dental treatments. In that case, it is very vital to carefully review the terms and conditions of the policy to ensure that it provides the coverage you need.