Santa’s Naughty Cousin, the Missing Tooth Clause

We see it all the time in our office, a patient hasn’t been to the dentist in years because they haven’t had insurance. They just recently enrolled in dental insurance and are looking to whip their teeth into shape. They have a missing tooth that they had extracted when they didn’t have insurance because it was all they could afford. When we check with insurance, insurance won’t pay for an implant, a bridge or a partial denture to replace that missing tooth. Why you may ask? It’s the Missing Tooth Clause.

In a way to mitigate cost of dental treatment, some insurance plans have a Missing Tooth Clause. The Missing Tooth Clause simply states that if a tooth is removed prior to your plan being active, the insurance will not pay any benefits to replace that tooth. In their view, your dental health is their responsibility only during the period you are enrolled in their policy. This is a tricky situation to navigate, so if you plan on replacing a tooth this year, you check with your dental insurance to make sure you will be covered.

Looking to avoid other pit falls in dental coverage? Give our office a call to discuss your dental insurance with you, 317-887-0700.

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