What Is Dental Health Insurance In India?

India’s dental health awareness has grown over the years. Case in point is the recent focus on marketing endeavours from brands like Smooth.ai, Clove Dental, Invisalign, etc. And as you can see above India’s dental care market is booming and so are its predictions for the next decade or so.

However, dental procedures/surgeries/seatings are not a pocket-friendly affair. This boost in awareness is common among the financially stable, but how do you afford dental procedures if you are worried about your monthly out-of-pocket expenses?

This brings us to dental health insurance plans in India that offer coverage for multiple procedures and dental treatments. While these health insurance plans extending dental benefits do offer some coverage, they have some major caveats. So, before you dive at the chance of purchasing such plans, it’s best to know the pros and cons of these policies and decide if they are at all worth your trust and money.

Top Dental Health Insurance Plans

What Is Dental Health Insurance?

A health insurance plan that offers an in-built or add/on to cover dental treatments and procedures is called a dental health insurance policy.

In general, health insurance policies don’t offer dental coverage unless dental surgeries are required due to cancer or some accident. This is a financial protection shield for insurers who fear frequent and substantial payouts. However, some health insurance providers extend dental coverage as an in-built feature or as an add-on. Such plans usually come with a cap on the coverage amount or extend the feature only if a higher sum insured is availed.

How to Choose the Best Dental Health Insurance Plans in India?

While all standard health insurance policies from reputed insurers come with limited dental coverage, even the plans that are considered dental health insurance plans are not exactly ideal. Usually, when choosing a dental health plan in India, you should be looking for one that has -

• No cap/Higher limit on the dental coverage sum insured: In short, your dental health insurance policy shouldn’t have a disease-wise sub-limit when it comes to dental health and its various treatments.
• No cap on the frequency of dental seatings: Look for plans that do not have clauses like “coverage for 4 seatings a year up to ₹4k/year.” Dental treatments are not a one-surgery solution. You have to expect that your root fillings, oral cavity treatments, etc. will take more than a single sitting.

This said, here’s a quick fact check - health insurance providers consider oral treatments like teeth alignment and root canal filing as cosmetic procedures and hence do not provide coverage for them. With the dental health insurance plans that offer coverage, the sub-limit/capping on the maximum insurance provided is not adequate.

Despite such limitations if you are still seeking a dental health insurance policy, here’s our list of some of the policies available in the market -

What are the Best Dental Health Insurance Policies in India?

1. Care Plus: The plan comes in two variants - Care Plus Youth and Care Plus Complete. The differentiating factor is the targeted age of the policyholders. Both variants are comprehensive policies offering a diverse list of perks. Moreover, the insurer’s consistent offering of no loading charges (additional charges on the base premium due to higher risks of payout over hospitalisation for pre-existing health issues) on any pre-existing conditions is a definite plus point. When it comes to dental treatments, the plan offers some coverage too -

• Based on the chosen sum insured, Care Plus offers capped coverage for dental treatments. If you have opted for coverage of ₹5 lakhs  - ₹7 lakhs, expect a maximum coverage of ₹1500. In case you opt for a coverage of ₹10 lakhs  - ₹25 lakhs, expect a cap of ₹2500.
• Any acute treatments on the natural tooth/teeth of a policyholder are covered under this perk, up to the limit specified as per the base sum insured. However, this treatment must be recommended in written format by a licensed dentist and make sure to be ready to submit this declaration to your insurer when you plan to file a claim.

Drawback: The sub-limit on the dental coverage makes it a measly offering considering the regular bills incurred after dental treatments/surgeries. Moreover, Care’s high complaint volume is a growing concern.

2. Niva Bupa Health Premia Platinum: Niva Bupa’s Health Premia Platinum is a truly comprehensive policy offering innovative perks that not many policies in the market do. However, the plan is exorbitant, to say the latest. With a sum insured offering ranging from ₹1 to ₹3 crores, the plan is specifically crafted for the financially well-off. The plan also offers dental coverage, the details of which have been discussed below -

• Dental coverage of up to ₹50k under its OPD Treatment and Diagnostic Services.
• Dental treatments, procedures and preventives, and restorative services related to disease, disorder and conditions on natural tooth/teeth are covered on an outpatient basis.
• This perk specifically excludes dental implants, CAD / CAM restorations and bone grafts.

Drawback: Health Premia Platinum is an extremely expensive plan that not many people may not be able to afford. Moreover, Niva Bupa’s complaint volume, issues with operational efficiencies, and hassles in claim settlement are crucial hurdles to consider.

Should You Purchase A Dental Health Insurance Policy?

Dental treatments are an expensive affair and since the procedures require multiple sittings, they take a heavy toll on the wallet of an individual. Dental health insurance policies are crafted to bridge that gaping financial crevice. However, when it comes to dental plans, here are a few things that you need to consider:

- Extensive dental coverage is available only with a high-end sum insured. So, you end up paying significantly higher premiums towards your substantial sum insured. Maybe you can tally the additional premiums you pay per year against the total cost of dental treatments you might undergo. This will help you analyse if dental health insurance policies are your best choice or not.

- Dental coverage is often provided as a part of the OPD add-on in health insurance. Health insurance plans that come with OPD perks (an in-built feature or mandatory add-on) are exorbitant in terms of their premiums.

- Dental coverage options almost always have a disease-wise sub-limit. Such cappings on the coverage fall short when you tally it against the overall dental treatment bill incurred. So, you have to pay considerably out of your pocket despite having a health insurance policy in place towards which you are already paying significantly high premiums.

Moreover, if you are focused on availing of a health insurance policy solely based on its dental coverage potential, you might end up missing out on the best health insurance policies in the market offering incredibly lucrative features like -

• No copayment
• No disease-wise sub-limits
• No room rent cappings
• Substantial restoration perks
• Domiciliary coverage
• Daycare treatment coverage
• High no-claim bonus
• AYUSH coverage
• Super Top-Up options
• No loading charges, etc.

Conclusion

While it is true that dental health insurance plans are growing increasingly popular, you need to look at the costs associated with such plans. Considering the financial weight of the premiums of dental health plans and the terms and conditions despite the cost, it seems you stand a better chance of paying for the dental treatments out of your pocket rather than expecting measly coverage for the same from your insurer.