Dental Insurance

Dental insurance is a base cover/health insurance benefit or an add-on offered under health insurance plans that cover dental treatment costs and related procedures like dental surgery and OPD consultations.

Since few insurers offer standalone dental insurance plans, they are mostly included under comprehensive health insurance plans. The policyholder can claim medical expenses along with dental treatment costs under dental insurance.

At Tata AIG, we offer dental insurance coverage under two of our MediCare health insurance plans: MediCare and MediCare Premium.

Due to reasons like inflation, rising medical costs, consumables, lab set-ups and required expertise, dental treatment costs can be quite expensive. To ensure that you do not have to dip into your savings or cut down on your other essential expenses, opting for dental care in insurance plans is recommended.

For example, if you are prone to dental conditions like oral cavities, gum disease, or illnesses that impact your dental health, then choosing Tata AIG’s MediCare Premier Plan is recommended as it covers in-patient and OPD dental treatments.

If you want more generalised dental insurance coverage, then our standard MediCare plan is best as it covers in-patient dental treatments under anaesthesia necessitated due to accidents, illness or injury.

• In-Patient Dental Treatment: This benefit is available under the standard MediCare plan and the MediCare Premier variant. We will cover medical expenses for in-patient dental treatment under anaesthesia necessitated due to accident/injury/illness.

• OPD Dental Treatment: This benefit is available under our MediCare Premier plan. We pay dental expenses up to a maximum limit of ₹10,000 per policy year annually for the following dental procedures:**

  • Root canal treatment (for single or multiple sessions).

  • Tooth extraction(s).

  • Tooth filling(s).

This benefit has a separate limit (over and above the base sum insured). So it will not affect your accrued cumulative bonus when you file for claims under this cover.

Lastly, OPD Dental treatments under the MediCare Premier plan are available to policyholders who have completed two years of continuous coverage with us at Tata AIG.

Since standalone dental insurance is hard to come by, it is best to opt for a medical insurance plan that provides dental insurance coverage in India. At Tata AIG, we offer two plans that offer insurance for dental treatment:** MediCare and MediCare Premier.

The MediCare Premier plan, in particular, offers maximum coverage of ₹10,000 for OPD dental treatments as its dental insurance cost in India. Here are some benefits you can find under both our plans

• Coverage For Dental Treatments and Procedures: Dental treatments are expensive, and consecutive trips to the dentist can significantly affect your savings.

  Opting for dental surgery insurance can save you money in the run and cut out any out-of-pocket expenses as you get coverage for in-patient and OPD treatments.

• Preventative Health Checkup: In addition to in-patient and OPD dental treatments, you also get dental examinations during your preventative health checkups. This ensures that any oral issues are caught during their initial stages, making them easier and less expensive to treat.

  Moreover, this benefit also makes you eligible for a tax deduction of ₹5,000, which is included in your maximum tax deduction (₹25,000/₹50,000) limit under your health insurance plan.

• Consumables Benefit: Any consumables used during hospitalisation for surgical or treatment purposes of illness, accidents or injury are covered under this benefit.

  Claims under this benefit are payable if you have filed an admissible claim under the in-patient hospitalisation cover for dental procedures.

• Cashless Facilities: You can claim cashless treatment at network hospitals for emergency and planned hospitalisations.

  This is beneficial as it mitigates any need to gather last-minute funds for treatments allowing for stress-free hospitalisations as we directly settle your bill with the hospital.

• Tax Benefits: Opting for either MediCare dental health insurance plan makes you eligible for health insurance tax benefits under Section 80D under the Income Tax Act. Here you can claim a maximum deduction of ₹25,000 on your health insurance premiums annually.

  This limit is increased to ₹50,000 if you are a senior citizen (over 60 years) or are the one paying the premium amounts for your senior citizen parents on their medical insurance plans.

The type and extent of coverage you receive for dental insurance in India will vary across insurance providers. This is why you must compare health insurance plans before purchase, as it will give you a thorough understanding of the scope of dental coverage you will receive under each plan.

In general, most dental covers in health insurance plans offer coverage for in-patient dental procedures required due to accidents. Meaning, you get coverage for dental procedures and treatments under anaesthesia due to accidents, injuries or illnesses that have caused damage to your teeth.

Other procedures like root canals, fillings, and extractions are mostly covered under OPD procedures.

If you are prone to dental problems and need to undergo regular dental procedures, it is always best to ask your insurance provider if they provide coverage for procedures that you regularly need to undergo and enquire about their waiting periods as well.

At Tata AIG, you can file either a reimbursement claim after you have paid for your medical expenses out of pocket or a cashless claim if you have opted for treatment at a network hospital.

Either claims process is applicable for in-patient or OPD dental insurance coverage so long as the dental treatment or procedure is covered under your medical insurance plan.

Here is a step-by-step explanation of how you can do either process.

For Reimbursement Claims

1. Visit the Tata AIG official website.

2. Click on ‘Claims’ on the top tab on the homepage.

3. Click ‘Initiate a Claim’ and click ‘Health’.

4. Login with your registered phone number and click ‘Confirm’.

5. Fill you the claims form and upload the required documents.

6. After submitting your claims form, an insurance agent will contact you to guide you through the reimbursement claims process.

For Cashless Claims

These claims can only be filed at network hospitals for planned and unplanned hospitalisations. To initiate a cashless claim, you must:

1. Notify the TPA (Third Party Administrator)/us through email or letter 48 hours before any planned hospitalisations/treatments. For emergency hospitalisations, we must be notified 24 hours after the treatment/hospitalisation.

2. Upon notification, we will check your coverage and eligibility and send an authorisation letter to the provider.

3. You have to provide your issued ID card along with any other information or documentation that is requested by the TPA/us to the network hospital.

4. If approved, we will directly settle the bill with the network hospital.

5. In case of a rejection of the cashless claim, you can still apply for a reimbursement claim, as a rejection of cashless claims in no way indicates rejection of the claim itself.

• Adequate Coverage: Look out for health insurance plans that provide not only dental insurance but also enough coverage for the dental treatments and procedures covered under the plan.

  Generally, it is recommended to choose plans where you can enhance coverage during policy renewals, like our MediCare plans. These plans offer more flexibility and allow you to increase or decrease coverage for the next policy year.

• Compare Plans: By comparing the different health insurance policies, you can find out which dental insurance plans suit your needs better.

  For example, if you need coverage only for in-patient dental treatments and other procedures such as tooth fillings, extractions and root canals, Tata AIG’s MediCare Premier health plan can be a suitable pick.

• Check the Inclusions: Your dental insurance plan may cover preventive treatments, routine dental checkups, and basic and essential oral healthcare treatments.

  Read your policy document to check if the dental plan covers these checkups and treatments and if any waiting period is involved before you can avail of it.

• Understand the Exclusions: Most dental insurance plans do not cover the cost of cosmetic treatments and surgeries. So, it is best to read through the policy document to be better informed about what treatments are not covered under your policy.

• Network Hospital Locations: In-patient dental procedures performed under anaesthesia require hospitalisations as they are often a result of injuries, accidents or illness.

  To make this process easier, we at Tata AIG have tied up with 8,000+ hospitals across India to ensure you get quality medical care and cashless facilities no matter where you are.

  You can also use our network hospital locator to check for network hospital addresses near your residence.

• Easy Claims Process: An easy claims process is a crucial factor to check for as it determines how quickly and efficiently your insurer will settle your claims. It could mean the difference between a simple, paperless claims process done with just a few clicks and a long, tedious process that could take hours.

  At Tata AIG, we also provide a claims tracking feature to ensure transparency, and it helps notify you of any additional documents needed during your claims process.

• Individual Health Insurance Plans: Individual plans offer dental cover in health insurance as a base cover or as an add-on cover. If it is an add-on cover, you must pay an additional premium to acquire its benefits.

• Critical Illness Plans: These plans offer coverage for medical expenses incurred during the treatment and management of critical illnesses. They may also offer dental surgery insurance if it falls under a critical illness insurance procedure covered by the policy.

• Family Insurance Plans: These plans cover dental insurance costs for all family members insured under the family floater plan.

• Personal Accident Plans: These plans cover dental procedures and treatments that require hospitalisation from accidents or injuries which may have also damaged a person’s teeth.

• OPD Health Insurance Plans: These plans may offer dental insurance for OPD dental treatments, consultations, diagnostic tests and medication.