Insurance

Does insurance cover the costs of dental anesthesia?

The answer to this depends on the specific situation and on your medical insurance’s specific policy. Nevertheless, with about 21 years of experience in providing anesthesia, I have observed the following:

• When the patient has “special needs” (e.g. autism, mental retardation, cerebral palsy, developmental delay, etc.), the chance that medical insurance reimburses some (or at times, even all) of the costs of dental anesthesia is fairly good.
• If, however, the patient does not have any “special needs,” it is fairly unlikely that medical insurance will reimburse the costs of dental anesthesia. What sometimes occurs though is that they apply a modest amount towards your policy’s deductible. Often though, in cases where no special needs are present, medical insurance pays nothing.
• Dental-Cal and Kaiser health policies do not cover the costs of dental anesthesia.

I would caution patients and their families regarding a practice that I have observed among some providers of dental anesthesia. At times, anesthesia providers aggressively assure patients that medical insurance will surely reimburse them for a large part or the entirety of their charges, all the while knowing that this is not true. This troubles me, and I would instead prefer to be upfront with patients and their families regarding the likely costs of dental anesthesia services: Unless your child has “special needs,” it is unlikely that your health insurance plan will reimburse you much at all for the costs of dental anesthesia. If another anesthesia provider tells you otherwise, I would exercise a healthy amount of skepticism and be financially prepared for his/her assurances to turn out to be false.