ACA and medically necessary dental care

[Rjx42]

I know ACA medical insurance (like Kaiser with CoveredCA) doesn't cover Dental for adults, but what if the dental care is medically necessary like tooth extraction due to an infection? I couldn't find a clear documentation saying one way or the other.

 

[mamipapi3263]

I know ACA medical insurance (like Kaiser with CoveredCA) doesn't cover Dental for adults, but what if the dental care is medically necessary like tooth extraction due to an infection? I couldn't find a clear documentation saying one way or the other.

Tooth extraction doesn’t fall under medical care. You need a dental plan.

 

[qureshia110]

I know ACA medical insurance (like Kaiser with CoveredCA) doesn't cover Dental for adults, but what if the dental care is medically necessary like tooth extraction due to an infection? I couldn't find a clear documentation saying one way or the other.

If you're enrolled in an ACA medical insurance plan like Kaiser through Covered California, dental coverage for adults is typically not included unless you have a separate dental plan. However, there are some exceptions where medical insurance may cover dental care if it's deemed medically necessary. For instance, a tooth extraction due to an infection could fall under this category if the infection poses a threat to your overall health. It's often treated as a medical emergency rather than a routine dental procedure. I recommend contacting your insurance provider directly for specific documentation or details about coverage in these cases. You might also check your plan's Summary of Benefits or Evidence of Coverage for more clarity.