Does Dental Insurance Cover Root Canals?
– What You Need to Know
Root canals may have a bad reputation, but they’re actually a routine dental procedure that’s become quicker, easier, and less painful thanks to constant advancements in technology. With modern techniques, root canals are now smoother than ever, and complications are rare.
But does dental insurance cover root canals?
Nobody wants to be caught off guard when they’re facing a root canal, especially when it comes to the cost. Imagine this: you’re in the dentist’s chair, feeling anxious about the procedure, only to discover that your insurance may not fully cover it. This can quickly turn an already stressful situation into a financial headache.
That’s why understanding the details of your dental insurance plan is crucial. So, let’s find out whether dental insurance covers root canal treatments and what factors affect the coverage amount.
A Root Canal is Rarely Optional – Here’s Why
Not every toothache requires a root canal, but it’s usually the only solution for a tooth with infected pulp since it won’t heal on its own. If left untreated, the infection can lead to an abscess—a pus-filled pocket—that weakens the tooth roots, making it harder to save.
Worse, the bacteria can spread to the gums, jawbone, bloodstream, or even the brain, potentially causing tooth loss, bone damage, or serious health issues.
While only a dentist can confirm if you need a root canal, common signs of infection or inflammation include:
- Pain in a specific tooth
- Swollen or red gums around the tooth
- Tenderness in the gums
- Facial swelling
- A tooth turning darker in color
- A visible hole or chip in the tooth
- A bump on the gums resembling a pimple
- Persistent pain when eating or drinking, even after removing hot or cold substances
How Much Does a Root Canal Cost?
The cost of a root canal can range between $600 and $1,400, depending on the tooth being treated. Front teeth are generally easier and cheaper to work on, while molars, due to their complexity, tend to be more expensive.
Here’s a breakdown of average costs by tooth type:
- Root Canal on Incisor: $850
- Root Canal on Premolar: $950
- Root Canal on Molar: $1,200
These prices may fluctuate based on the extent of the damage.
It’s important to note that not all dentists can perform root canals. Since endodontics focuses on treating the tooth’s inner pulp, only about 3% of dentists are trained as endodontists.
This means that you’ll likely need to see a specialist for a more accurate estimate, especially if the tooth requires significant intervention.
Factors Influencing the Cost of a Root Canal
The Type of Tooth Being Treated
Front teeth and bicuspids have fewer, more accessible roots, making them easier and cheaper to treat. However, premolars and molars have multiple, larger roots that are harder to reach, leading to a more complicated—and often pricier—procedure.
The Type of Crown You Choose
After a root canal, a crown is needed to seal the tooth, and crowns come in different materials at various price points. For back teeth that aren’t visible, a more affordable option may suffice. But for teeth that show when you smile, you might opt for a higher-quality, aesthetically pleasing crown, which might cost more.
Severity of the Infection
If caught early, the infection is easier and less costly to treat. However, a more advanced infection that has spread will require more extensive care, increasing both the time and expense.
Associated Pre- and Post-Procedure Costs
The overall cost of a root canal often includes multiple elements, such as X-rays, the visit fee, anesthesia, infection removal, refilling the tooth, and sealing the entry point, all of which contribute to the final bill.
Does Dental Insurance Cover Root Canals?
Dental insurance typically offers less coverage than standard medical insurance, and your plan may not fully cover root canals. Depending on your coverage, you could end up paying nothing, a portion of the cost, or the entire amount out-of-pocket.
Key Elements Influencing Coverage of a Root Canal
Coverage Terms
Some dental insurance plans focus mainly on preventative care, like cleanings and checkups, and may not cover root canals at all. To avoid surprises, it’s essential to review your policy carefully, talk with your dentist’s office manager, or contact your insurance company to confirm if root canals are included in your coverage. Even if they are, you might still need to pay a portion of the cost.
Deductible
Most dental insurance policies come with a deductible, meaning you’ll need to pay a certain amount out-of-pocket before your insurance kicks in. For example, if your deductible is $1,000 and the root canal costs $1,000, your insurance won’t cover anything until you’ve met that amount. However, once the deductible is met, your insurance will cover any future treatments within the same year.
Co-Insurance
Co-insurance means you and your insurance company share the cost of your dental procedure. For example, after meeting your deductible, your insurance might cover 80% of the expense while you pay the remaining 20%. If your root canal costs $1,500 and you have a $1,000 deductible, you’d pay $1,100. However, if you’ve already met your deductible from a previous procedure, you’d only need to cover 20%, or $200, of a $1,000 root canal. Most insurance plans include co-insurance to split costs between you and the insurer.
Waiting Period
Many dental plans have a waiting period for major procedures like root canals, often requiring you to pay premiums for 12 months before coverage kicks in. If you enroll in dental insurance solely to cover a root canal, you might end up paying more in premiums, deductibles, and co-insurance than if you paid for the procedure upfront. Additionally, delaying a needed root canal for a year can give tooth decay more time to worsen.
Maximums
Insurance plans also have annual coverage limits, or maximums, which cap how much they’ll pay in a year. While a single root canal is unlikely to hit the maximum, a series of procedures could. Keeping track of your yearly limit is essential if you’re planning multiple treatments.
Conclusion
In the long run, skipping a root canal can lead to significantly higher costs than the procedure itself, as it may result in more severe issues down the road. Without treatment, you might face additional complications such as ongoing infections, tooth extractions, dental implants, or even serious health problems.
At Mellert Dental Associates in Torrance, CA, we’re committed to providing high-quality, comprehensive dental care, including root canals, at a reasonable cost. Please call 310-543-1234 or schedule an appointment to get your root canal procedure.
FAQs
How much does a root canal cost with insurance?
Typically, dental insurance covers between 50% and 80% of the cost of a root canal after you’ve met your deductible. While many insurance plans classify root canals as preventative care—since they aim to save the tooth from extraction—they usually don’t cover the full cost. Therefore, you should be prepared for some out-of-pocket expenses.
How can you pay for a root canal if your dental insurance doesn’t cover the procedure?
If your dental insurance doesn’t cover your root canal, consider using payment plans, CareCredit, or other financing options such as HSA’s or FSA’s. Alternatively, paying out of pocket directly to your dentist can also be an option.
