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Why Doesn’t Health Insurance Include Dental Coverage?  

Why Doesn’t Health Insurance Include Dental Coverage?  

Have you ever wondered, “why aren’t dental visits covered under my medical insurance?” You’re not alone. After all, your mouth and teeth are connected to the rest of your body, and we know that a bad dental infection can jeopardize your overall health. It seems a bit hypocritical to have medical insurance that covers the health of our body, but excludes the teeth.  

The only time when “dental” types of procedures tend to be covered under medical insurance is when they involve oral surgery or serious injury require hospitalization. Examples might include wisdom teeth removal, jaw surgery after a car wreck, oral cancer therapy, general anesthesia, etc.   

In some cases, dentistry is a lot like optometry; both types of specialist care are excluded from the conventional medical care system, even though it seriously impacts your health and quality of life. Without healthy eyes, we can’t see or drive properly, and without healthy teeth, we aren’t able to eat and nourish our bodies in ways that keep it strong.    

Is Dental Care Covered Under Government Medical Programs?  

Depending on which state you live in, only children are legally required to have access to dental coverage under medical insurance plans purchased through the ACA Marketplace. Even then, the medical benefits are a separate package that’s not part of the primary health plan. Medicaid is similar: selective dental procedures are only included for kids up to the age of 18, and certain women during pregnancy. Not even Medicare covers routine dental services.   

A Trip Back in Time  

It’s thought that the original separation between medicine and dentistry goes back to the early 1800s. In those days, a barber shop was where someone would go to get a tooth pulled. Although there were already licensed doctors practicing at that time, the nations’ first dental school didn’t open until 1840.   

These circumstances set up a path that lead to a large distinction between the providers who offered healthcare related to the mouth, and medical services related to the rest of the body. Although connected, the provider sources were entirely different entities. You can imagine what this likely did as organized medicine, dentistry, and health regulations began to be implemented.   

Fast Forward a Few Years  

In the 1960s, only 2-3% of the country had any type of dental insurance. In 1965 when congressional leaders instituted Medicaid, dentistry wasn’t valued as much of a priority as medical care was. 

But now, things are different. We as a nation understand that our oral health can significantly impact our quality of life or even contribute to underlying medical conditions. While medical and dental experts realize this, the oral-systemic connection remains disconnected when it comes to the type of health benefits offered through employers, government aid programs, and medical insurance companies.   

Unfortunately, dentistry and medicine have become so disconnected from each other, that it makes them almost impossible to mesh them back together under the types of regulations set forth through licensing agencies, healthcare facilities, and legal systems.   

“It’s All Preventable”   

In theory, medical insurance is to protect you from a serious, unexpected illness or injury. With dentistry, most — not all, we know — but most dental problems are preventable. If you’re eating a balanced diet, brush regularly, floss daily, and see a dentist for early diagnosis of possible problems, you need less intervention care. A cavity caught today can have a small filling, rather than turn into an abscessed tooth in need of a root canal several months later. Oral health problems become a matter of self-maintenance and early screening with a dentist.   

But life happens. We forget to floss, a child chips a tooth, or an unexpected toothache leaves us unable to go to work. At that point is when most of us need to have some type of dental benefits to reduce the overall cost of what it takes to repair or smiles.   

If you don’t have dental insurance, you’re not able to take advantage of those included, preventive dental checkups, x-rays, and cleanings that could be the difference in keeping your teeth healthier, longer.   

Affordable Solutions for People Without Dental Benefits  

Maybe one day our government officials, medical regulatory agencies, and national dental organizations will come together to reform healthcare in a way that includes dentistry within health insurance. But for now, there’s no light at the end of the tunnel.   

Thanks to Aetna Dental Offers, you can get great, affordable dental care even if you don’t have dental insurance through your employer’s medical benefits package. Members safe 15-50% on services like dental exams, cleanings, fillings, and more through this unique savings plan. Contact us today to learn more about insurance alternatives for dentistry. 


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