Dental Cover In Health 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 stand-alone 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.

Dental health is very essential for individuals. However, getting treatment can be very expensive if the individual doesn’t have dental insurance coverage. The reason behind that is dental procedures employ innovative solutions and machines for treatment. Below are some of the reasons why individuals prefer to invest in the best dental insurance plans.

Peace of Mind - The very first reason for investing in dental insurance in India is to have peace of mind that a person's oral care is secured against all odds. The dental health insurance policy will cover oral diseases if they happen within the policy tenure.

Maintain Oral Health - Another reason for investing in a dental insurance plan is to maintain oral health. Regular checkups or cleaning is necessary to avoid developing significant oral disease. Under the dental health insurance policy, the policyholder will have the advantage of having regular checkups, teeth cleaning, etc, in the clinic.

Cut Down Hefty Medical Charges - Dental healthcare requires specialised professionals, testing, consumables, etc, which can make a treatment very costly for individuals with no health insurance plans with medical coverage. Paying for all this out of pocket can put an immense financial burden on people and can derail their budgeting. But with dental insurance that covers implants and other treatments, individuals can get top-notch oral care without breaking the bank.

Top-Notch Dental Care - Last but not least, the reason to get a health insurance policy with dental insurance coverage is to have access to top-notch dental care. If an oral care treatment goes wrong it could double up the treatment cost. With dental insurance, individuals will have access to skilled professionals with years of experience and innovative treatment plans.

When individuals purchase a health insurance policy with dental coverage, the policyholder pays an insurance provider insurance premium in exchange for service. Most insurance companies do offer in-built dental coverage for some specific dental treatments with their health insurance plans.

However, health insurance plans with dental insurance coverage come with a waiting period. In that waiting period, individuals can not claim for dental insurance services. Once a waiting period is over, policyholders can avail of the dental insurance benefits either in the listed network hospitals or in dental care hospitals.

The insurance company will reimburse for the dental medical expenses after filing a claim based on the policy condition. The claim procedure may take some time.

Below are some promising health insurance plans that offer dental coverage in India.

Individual Health Insurance Plans: Individual plans offer dental coverage 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.

The eligibility criteria for dental insurance coverage with a health insurance policy may vary from insurance provider to provider. The criteria generally depend on the type of plan or insurance policy. The general criteria for purchasing a health insurance policy with dental coverage are listed below.

• The minimum age criteria for individual policies is 18 years, and the maximum age can be 65.

• For a family floater health plan, the child's dental health is covered from 90 days of age.

The eligibility criteria for dental insurance coverage with a health insurance policy may vary from insurance provider to provider. The criteria generally depend on the type of plan or insurance policy. The general criteria for purchasing a health insurance policy with dental coverage are listed below.

• The minimum age criteria for individual policies is 18 years, and the maximum age can be 65.

• For a family floater health plan, the child's dental health is covered from 90 days of age.

Since stand-alone 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 long 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.

Recommended Dental Insurance Plans

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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, that 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.

Suppose you are prone to dental problems and need to undergo regular dental procedures. In that case, 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.

Below is the list of documents required for filing dental insurance claims.

• Documents to prove a patient's identity, such as Aadhar card, passport, etc.

• Original health insurance with dental coverage policy document.

• All the medical or dental care bills from the clinic and hospitals.

• Document to verify patient address such as ration card, driving licence, etc.

• Any additional documents needed by the insurance company.

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 **

Step 1: Visit the Tata AIG official website.

Step 2: Click on 'Claims' on the top tab on the homepage.

Step 3: Next, click on 'Initiate a Claim' and then click on 'Health'.

Step 4: After that, log in with your registered phone number and click 'Confirm'.

Step 5: Next, fill out the claims form and upload the required documents.

Step 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:

Step 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.

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

Step 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.

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

Step 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.

Below are some of the points to keep in mind while buying dental insurance coverage.

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, suppose you need coverage only for in-patient dental treatments and other procedures such as tooth fillings, extractions and root canals. In that case, 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.

In these uncertain times, dental health can't be overlooked in any way. And with a health insurance plan with dental health coverage, individuals can look after oral care without affecting their finances. However, before purchasing any insurance plans, it is best to check the coverage, inclusions and exclusions to make an informed decision.