does it cover?

Does dental insurance cover root canals?

DOESITCOVER.COM · GENERAL VERDICT · DOESITCOVER.COM · GENERAL VERDICT ·USUALLYCOVERED

Root canals are standard restorative dental care and most plans cover them — as a basic or major service, paying a share after any deductible up to your annual maximum.

What flips the answer

  • Covered when

    You have a plan with basic and/or major services and have met any deductible or waiting period — the standard covered case.

  • Not covered when

    Your plan is preventive-only (cleanings and exams) with no basic or major restorative benefit.

  • Not covered when

    You've already exhausted the annual maximum on other treatment this year.

A root canal treats infection or damage inside a tooth, so it's clearly medical rather than cosmetic dental work. Nearly all dental plans that offer more than preventive-only coverage include endodontic treatment like root canals.

Plans differ on the tier. Some classify root canals as a basic service (often reimbursed at a higher percentage), others as a major service (reimbursed at a lower percentage and sometimes subject to a waiting period). Either way you'll usually owe your deductible plus coinsurance, and the payout counts against the annual maximum.

A root canal is also frequently followed by a crown to protect the tooth, which is billed and covered separately under the crown rules. Your plan's schedule of benefits shows which tier applies and what percentage it pays.

That's the general answer. Yours is written in your actual policy.

Drop in your policy or benefits document and get the answer for your exact coverage — with the clause it comes from. Nothing is stored.

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Sources

  1. [1]HealthCare.gov — Dental coverage in the Marketplace
  2. [2]IRS Publication 502 — Medical and Dental Expenses

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