Dental insurance is a type of health insurance that covers treatment including dental checkups, fillings, tooth extractions, and dental surgery for your teeth or the supporting structures.

Dental insurance coverage may be offered as an in-built coverage or as an add-on under a health insurance plan.

At TATA AIG, we provide both these options, with coverage for outpatient (OPD) dental treatments and inpatient hospitalisation.

Here’s a step-by-step process of how dental insurance works:

The premium cost of a dental health plan varies with a wide range of factors, including the policy type, sum insured, rider cost, lifestyle habits, medical history, and more. The premium varies across different plans and depends on the number of persons covered. Explore the important factors that influence dental insurance costs:

Given the complexities of considering multiple factors, the best way to know your dental insurance costs is to use a health insurance premium calculator. Enter the required details, such as family members and age, to know the details.

Here are the different types of TATA AIG health insurance plans and add-ons that offer dental treatment coverage:

1. TATA AIG MediCare Premier

Key Features:

• This comprehensive plan covers hospitalisation expenses for dental treatments that need anaesthesia.
• It also offers OPD dental treatment coverage with limits ranging from ₹10,000 to ₹20,000 based on the sum insured. It covers tooth extractions, fillings, and single or multiple-sittings of root canal treatments after a waiting period of 2 years.
• The OPD dental treatment benefit has a separate coverage limit over and above the base sum insured. And claims under this benefit do not affect your No Claim Bonus.

2. TATA AIG Elder Care Policy

Key Features:

• This senior citizen plan covers preventive health consultations once every policy year.
• Dental checkups are included under this benefit and cover general screening tests.

3. TATA AIG Criti MediCare

• This critical illness insurance plan provides dental health coverage for full dental reconstruction.
• It covers full-mouth and dental reconstruction surgery if it is medically necessary due to an accident.

4. TATA AIG MediCare Plus

• The MediCare Plus is our super top-up health insurance that provides additional coverage when the sum insured under your existing health insurance plan is exhausted.
• It covers hospitalisation expenses for dental treatments, including examinations, extractions, fillings, and surgery due to accidents, injuries or illnesses.

5. OPD Care Rider(Optional Add-on)

• It covers in-person consultations with dental specialists.
• This OPD rider is applicable to a wide variety of dental procedures, including teeth extractions, root canal treatment, restorations, fillings, pulpectomy, and therapeutic pulpotomy.
• It also covers accidental damage to natural teeth if the treatment is received within 30 days.

Dental health coverage varies as per your selected plan. Explore the inclusions and exclusions:

What’s Covered

• Inpatient Hospitalisation: Covers hospitalisation costs, including room rent, nursing and operating theatre expenses, for necessary dental treatments.
• OPD Treatment- Dental: Reimburses OPD expenses, including tooth extraction, filling and root canal treatment under a separate coverage limit.
• Annual Health Consultations: Every policy year, it covers an annual dental checkup for general assessment at an empanelled service provider.
• OPD Dental Rider: The OPD Care rider covers dental consultations, X-rays, accidental damage and procedures like RCT, extractions, filling, restoration, pulpectomy and therapeutic pulpotomy.
• Full Dental Reconstruction: Full dental or oral reconstruction surgery necessary due to an accident.

What’s Not Covered

• Medical expenses for treatments within a waiting period, if applicable
• Cosmetic or plastic surgery if it is not medically necessary.
• Any treatment, supplies or expenses related to unproven treatments.
• Under the OPD rider, any cosmetic or aesthetic treatment or procedures, including scaling, polishing, bleaching, braces, aligners, etc.
• Under the OPD Care rider, treatment for accidental damage to natural teeth after 30 days of the accident.
• Under the OPD Care rider, teeth damage when caused by the consumption of pan masala, gutkha, tambaku, alcohol, etc.

Disclaimer: The above inclusions and exclusions depend on your selected plan and are subject to our terms and conditions. Please read the policy document carefully to know the complete terms.

Eligibility criteria for insurance for dental treatment vary depending on the health insurance plan or rider you choose.

Here are the standard eligibility criteria applicable to TATA AIG MediCare Premier:

Eligibility Criteria

Documents Required

Purchase Process

1. Scroll to the top of this page and click on ‘Want to buy insurance’.
2. Choose the number of family members and click on ‘Get Plan’.
3. Provide the required details, such as age, mobile number and PIN code. Then, click on ‘See Plans’.
4. Review the plans available and choose health insurance with dental cover. Modify the coverage limit and add the dental OPD rider if needed.
5. View the premium breakup and, if acceptable, pay it to purchase the plan.

Renewal Process

1. Scroll to the top to find the ‘Renewal’ menu. Choose ‘Health’ from the list of insurance types.
2. Enter your policy number and click on ‘Renew’.
3. Review your existing policy details. Modify the coverage and add a dental insurance rider as per your needs.
4. View the revised premium and pay it to renew your plan.

Cashless Claim- Emergency

1. Inform TATA AIG about your hospitalisation by calling the helpline (022-6489-8282).
2. Send the cashless claim form from the hospital within 24 hours of your admission, along with the necessary documents.
3. Wait till we verify your claim and send an authorisation letter to the hospital to directly settle your dental treatment bills.

Cashless Claim- Non-Emergency

1. Inform us about your upcoming treatment as soon as possible.
2. File a cashless claim online, by email or by letter at least 48 hours before your planned hospitalisation.
3. Wait till we send you a confirmation letter and inform the hospital about your scheduled treatment.
4. Upon arrival, submit your health card and confirmation letter detailing your dental treatment to the hospital staff.

Reimbursement Claim

1. Pay for the treatment and collect essential documents, such as bills, prescriptions, medical certificates and a discharge card.
2. Fill out and submit a reimbursement claim form along with all supporting documents.
3. Wait till we receive your claim, process and verify it and send the reimbursement directly to your account.

Understand the waiting period, limits and deductible requirements to maximise dental cover in health insurance:

• Waiting Period in Dental Insurance

The waiting period is the time you must spend to be able to file a dental insurance claim. Every health insurance plan comes with a 30-day initial waiting period when only accident claims are allowed. There are also waiting periods for pre-existing diseases (3 years) and specific procedures or illnesses (2 years). For the OPD dental treatment coverage feature of TATA AIG MediCare Premier, a 2-year waiting period is applicable.

• Limits of Dental Insurance

Sub-limits are monetary caps on certain features and procedures covered under a dental health insurance policy. Sub-limits may apply to hospital room rent, OPD covers, ambulance charges, preventive health checkups and other benefits. Ensure you check the limits before buying a health plan.

• Deductibles in Dental Insurance

A deductible is a fixed, pre-decided amount you must pay from your own pocket before your dental insurance plan covers the rest. It may apply depending on the health insurance policy or rider you choose. Please refer to your policy document for the applicable details.

Myth 1: Young and Healthy People Don’t Need Dental Coverage

Health risks are not limited to older individuals. Dental emergencies, accidents while playing sports and tooth injections can happen to anyone regardless of their age or health conditions.

Myth 2: You Need to Use Your Insurance Each Year

This is a common misconception that you have to use the health insurance benefits as your policy is renewed each year. For every claim-free year, you gain a cumulative bonus that continues to compound.

Myth 3: You Need a 24-hour Hospitalisation to Make a Claim

The 24-hour limit only applies to inpatient hospitalisation cover. It does not apply to OPD (outpatient department) cover, which pays for consultations, diagnosis and treatment at clinics without requiring hospitalisation.

Myth 4: Dental Insurance Covers Every Expense

Every insurance plan has its own set of exclusions stated in the policy wording document. Ensure you read it thoroughly to know what expenses are not covered by your chosen dental insurance.