Is Dental Treatment Covered in Health Insurance Policy in India?
To simply put it, a dental health insurance is a health insurance that also covers for your necessary dental treatment expenses. Typically, many standard health insurance plans do not offer insurance for dental treatments and care. However, at Digit we cover the same under our OPD benefit which is included as part of our Digit Health Care Plus plan.
Why do you need a Dental Health Insurance?
Dental treatments are usually expensive due to innovations, inflation, expensive set-up, materials and lab work involved.
OPD costs in India account for up to 62% of total healthcare costs! (2)
The World Dental Federation states that, globally, oral health diseases affect more than 3.5 billion people! (3)
What’s great about Digit Health Insurance covering Dental treatments?
Simple online processes: Everything from buying a health insurance with dental treatments to making dental health insurance claims is simple, digital, quick and hassle-free! No hard copies required, even when you make a claim!
Covers Pandemics: If there’s anything that 2020 has taught us, it is that everything is uncertain! Whether it’s the COVID-19 or any other virus, pandemics are covered!
No age-based copayment: Our health insurance with OPD cover, including dental treatments comes with no age-based copayments; i.e. during claims, you pay nothing from your pocket!
Cumulative bonus: It doesn’t matter if you don’t make any claims during the year - you can still benefit! You can get yearly, cumulative bonuses for every claim-free year!
Complimentary annual health checkups: Did you know most healthcare issues, including that of dental care can be avoided with regular checkups? This health insurance comes with a renewal benefit of complimentary annual health checkups, so you’re always up to date with your overall health and wellbeing!
Get treated at any hospital of your choice: Choose from 16400+ of our network hospitals in India for cashless claims or opt for a reimbursement.
What’s covered in Digit Health Insurance with OPD cover, including coverage for dental treatments?
| Smart + OPD | |
Dental TreatmentsOut-patient dental treatment for the immediate relief of dental pain; taken from a dentist, provided that we will only pay for X-rays, extractions, amalgam or composite fillings, root canal treatments and prescribed drugs for the same, and teeth alignment for adolescents. |
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| OPD Coverages | |
Professional FeesFees for medically necessary consultations and examinations by medical practitioners to assess your health for any illness. |
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Diagnostic FeesMedically necessary out-patient diagnostic procedures such as x-rays, pathology, brain and body scans (MRI, CT scans) etc... used to make a diagnosis for treatment from a diagnostic center. |
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Surgical TreatmentsMinor Surgical procedure such as POP, suturing, dressings for accidents and animal bite related outpatient procedures etc. carried out by a Medical Practitioner. |
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Medicine BillsMedication drugs and medicines as prescribed by your medical practitioner. |
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Hearing AidsHearing aids required for serious hearing conditions are covered. |
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| Other Coverages | |
All Hospitalization, including for CoronavirusThis covers for hospitalization expenses due to an Illness, Accident or even a Critical Illness. It can be used to cover for multiple hospitalizations, as long as the total expenses are up to your sum insured. |
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Daycare ProceduresHealth insurances generally cover medical expenses only for hospitalizations exceeding 24 hours. This covers for medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement. |
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No Age Based CopaymentA Copayment refers to the amount of money you need to pay from your pocket, during a health insurance claim. In our plans, there is no age based copayment involved! |
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No Room Rent CappingDifferent categories of rooms have different rents. Just like how hotel rooms have tarrifs. With Digit, some plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured. |
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No ICU Room Rent CappingICU (Intensive Care Units) are meant for serious patients. The level of care is higher in ICUs, which is why the rent is higher too. Digit does not put any limit to the rent as long as it is below the your Sum Insured. |
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Cumulative BonusGet rewarded for every claim free year. If you do not make any claim in a year, some plans reward you with a discount in the next year. This extra discount is called Cumulative Bonus |
10% CB for each claim free year (Up to 50%) |
Road Ambulance ChargesRoad Ambulance Charges |
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Complimentary Health CheckupsAnnual health checkups are important to ensure you are aware of your overall health and well-being. This is a renewal benefit that allows you to reimburse your expenses towards any annual medical tests and checkups, at any hospital of your choice. |
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Post Hospitalization LumpsumThis is a benefit you can use to cover all your medical expenses post hospitalization, at the time of discharge. No bills required. You can choose to either use this benefit or use the standard post-hospitalization benefit, through the process of reimbursement. |
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Psychiatric Illness CoverIf due to a trauma, one has to be hospitalized for a psychiatric treatment, it will be covered under this benefit. However, OPD consultations are not covered under this. |
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Bariatric SurgeryThis coverage is for those facing organ issues due to their obesity (BMI > 35). However, in case the obesity is due to eating disorders, hormones or any other treatable conditions, this surgery cost will not be covered. |
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| Additional Covers you can opt for | |
Maternity Benefit with Newborn Baby CoverIf you plan on having a baby in the next two years or so, you can opt for this. It covers for child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days. |
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Zone UpgradeEvery city falls either in Zone A, B or C. Zone A has Delhi and Mumbai. Zone B has cities like Bangalore, Hyderabad, Kolkatta. The zones are divided as per medical costs. Zone A cities have highest medical costs therefore the premium to get a treatment under health insurance in these cities is a bit higher. If you wish to get treated in a bigger city than where you live, you can upgrade your plan for the same. |
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| Get Quote |
What’s not covered?
This insurance for dental treatment does not include expenses for cosmetic surgeries, dentures, dental prosthesis, dental implants, orthodontics, orthognathic surgeries, jaw alignment or treatment for temporomandibular (jaw), or upper and lower jaw bone surgery and surgery related to the temporomandibular (jaw) unless necessitated by an acute traumatic injury or cancer.
Apart from this, the OPD cover excludes expenses incurred towards Spectacles, Contact Lenses and Physiotherapy, Cosmetic Procedures, Ambulatory Devices like Walkers, BP Monitors, Glucometers, Thermometers, Dietician Fees, Vitamins and Supplements.
How to file a claim?
Reimbursement Claims - Let us know in case of a hospitalization within two days of admission at 1800-258-4242 or email us at healthclaims@godigit.com and we'll send you a link where you can upload your hospital bills and all relevant documents to process the reimbursement.
Cashless Claims - Choose the network hospital. You can find the complete list of network hospitals here. Display e-health card to the hospital helpdesk and ask for the cashless request form. If all is good, your claim will be processed then and there.
If you have claimed for Coronavirus, make sure you have a positive test report from an authorized centre of ICMR – National Institute of Virology, Pune.
Benefits of having a Health Insurance that covers Dental Treatments
Dental treatments can be expensive and this is mainly because of the continuous innovation in the field, the expensive setup and the amount of laboratory work involved. Having health insurance with dental coverage ensures your dental treatment expenses are at bay, and you save more whilst still taking care of your oral health!
People often undermine dental health and that can lead to more serious oral health issues in the future. In fact, whilst health experts recommend visiting a dentist at least once a year, in India it was found that 67% of the population didn’t unless their oral condition reached a point where going to the dentist was inevitable. A dental health insurance will ensure you don’t leave dental issues for the last minute, and get the required treatment at the right time, without having to worry about your finances!
Usually, most standard health insurance plans do not cover for dental treatments. However, the biggest benefit of this health insurance with OPD cover, including dental treatments is that you get coverage beyond the standard. You get all the benefits of a standard health insurance plus the benefit to cover for OPD expenses, including dental treatments!
As mentioned above, in this case, an insurance for dental treatment doesn’t only give you the benefit of coverage for your necessary dental treatments but, also gives you other benefits such as coverage for daycare procedures, hospitalization for all other illnesses including the COVID-19, complimentary health checkups and, no room rent capping among other benefits.
The best part about any health insurance is that apart from receiving financial benefits related to your health, you also get other financial benefits such as annual tax savings based on the health insurance premium you pay, up to Rs 25,000!
How to ensure healthy Dental hygiene and wellbeing?
You’ve probably heard this since childhood but it still rings true and sadly enough, people still need to be reminded of it! The key to good oral hygiene is literally just brushing twice a day and you could floss too when required to ensure there is no dental plaque between your teeth.
One of the most common recommendations by health experts is that you should visit your dentist at least once a year if not twice, even if you feel like you have no dental problems. Many times, you may never know what’s going on inside until it’s too late! And you know what they say, tooth aches are one of the worst aches there is. Going for regular dental checkups ensures your oral health is in check!
Drink lots of water. Yes, the age-old rule is valid not only for overall health but, good dental health too!
If you have diabetes, work on maintaining your levels not only for your overall health but it also affects your oral health. This will ensure you avoid any gum diseases and if you do tend to have a gum disease, then get the same treated as soon as possible!
Avoid using tobacco products, including smoking. They’re not only bad for your lungs, but terribly bad for your oral health too!
FAQs about Dental Health Insurance
Does dental health insurance cover root canal treatments?
Yes, if your doctor has prescribed the need for the same, root canal treatments too are covered under this health insurance for dental treatments.
Does dental health insurance cover for tooth extractions?
Yes, since tooth extractions are often necessary due to severe pain and discomfort, they are covered under this dental health insurance.
Does dental health insurance cover dental implants?
No, this dental health insurance does not cover dental implants.
Does a dental health insurance cover for braces?
Yes, this dental health insurance covers for teeth alignment but, only for adolescents.
What do you mean by OPD?
All those treatments and medical procedures that don’t require you to be hospitalized are considered as OPD (out-patient department). All your doctor consultations and diagnosis come under this 😊 You can read more about OPD benefits here too.