Will Dental Insurance Pay for IV Sedation?

I had two consultations with dentists, who agreed I needed two dental implants and three crowns. I am terrified of the dentist and will need sedation for the dental work. One dentist only uses nitrous oxide in the office but would refer me to a specialist for implant surgery. The other dentist uses nitrous oxide and sedation pills. I know more than nitrous oxide is needed regardless of the procedure. I read about IV sedation and that it is stronger than other options. I am willing to switch dentists for more sedation, but I need to schedule consultations after finding dentists who use IV sedation. – Thanks. Paul from Lakeland, FL

Paul,

Thank you for contacting Dr. Lacy’s office. Many anxious patients require sedation to get dental work. We commend you for caring for your oral health and researching your options.

Will Dental Insurance Pay for IV Sedation?

Whether dental insurance provides coverage for IV sedation depends on the plan level and your needs as a patient. Some insurance companies offer benefits toward IV sedation when it is medically necessary based on several factors, including:

  • Dental procedure type
  • Patient’s physical, intellectual, and medical needs
  • Patients for whom alternatives are ineffective
  • Extraordinarily fearful or anxious patients
  • Patients who have experienced dental trauma and require potent sedation options

We recommend contacting your insurance company to find out how much if any, sedation dentistry procedures they cover. Some insurance companies that provide coverage limit the number of hours of IV sedation dentistry for which they will provide benefits. For example, dental insurance may provide benefits for up to one or two hours of sedation, and you would be responsible for the remaining cost.

Your insurance company may ask you to provide a pre-treatment estimate from your dentist to estimate your out-of-pocket costs.

Plano, Texas, female dentist Dr. Miranda Lacy sponsors this post.