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Dental sedation can be necessary in cases where the patient is extremely fearful or uncomfortable undergoing specific procedures. While common in children, adults can suffer from dental anxiety, too, making them vital in particular situations.

As with other places, dental sedation costs in Australia depend on a patient’s requirement and the duration of sedation needed, as determined by licensed anaesthetists. Inhaled sedation is typically the cheapest, with some starting at AUD$200, while intravenous (IV) sedation is generally the costliest, starting at AUD$850.

These added costs can be a financial burden to those who need dental procedures. In these situations, would-be patients are inclined to ask:‘Is sedation dentistry covered by dental insurance?’ Discover the answer below.

Understanding Dental Sedation Services

Sedation can help manage pain, control anxiety, and reduce patient movement during a procedure. Sedatives are used in numerous medical treatments, including some dental procedures.

Dental clinics and service providers offer different dental sedation coverage, which includes the following:

  • Oral sedation
  • Inhaled sedation
  • IV sedation

A licensed anaesthesiologist determines the administration method based on several considerations. Besides the delivery methods, these professionals will consider the dental procedure to pinpoint the type of sedation a patient requires, including minimal, moderate, and deep sedation.

Does Dental Insurance Cover IV Sedation?

The longer sedation you need, the higher the price. As mentioned, IV sedation is the most expensive type. Whether your insurance policy will cover such costs will depend on your situation and insurance policy. Public or private insurance providers don’t cover sedation costs, regardless of the type and administration method.

Dental Sedation vs. Local Anaesthesia

Dental sedation and local anaesthesia are different. The former is administered to reduce patient sensitivity and discomfort, while the latter is used to numb the tissues and block the nerves that transmit pain.

Unlike sedation, anaesthesia is often considered essential to most medical and dental treatments. Hence, they’re covered by insurance. Conversely, dental sedation services are mostly regarded as non-essential by insurers.

Government-backed Dental Insurance

In Australia, Medicare covers an exhaustive list of common health services. Unfortunately, Medicare only covers essential dental services for qualified adults and children.

Public dental coverage and eligibility vary from state to state. In some territories, patients aged 2 – 17may be eligible for free basic dental care totalling AUD$1,026 over two calendar years, excluding cosmetic dentistry or orthodontic treatments. Otherwise, patients unqualified for the said coverage must spend their money or get private dental insurance.

Private Dental Insurance

In Australia, individuals can purchase private health and dental insurance to cover the costs of expenses not covered by Medicare. This private health coverage often includes dental treatments, but the types of services covered will depend on the policy. More inclusions mean higher premiums.

Dental sedation coverage isn’t included in the routine and major dental services offered by private health insurance companies in Australia. At the same time, insurance providers will differ on how much they will pay for certain services. Some firms limit their coverage to a list of accredited practitioners. It’s best to check the terms to know if your private dental insurance covers sedation.

Dental Sedation Costs

So, how much does dental sedation cost? Generally, these services are reasonably priced and affordable. But as a quick reference, dental IV sedation costs are generally the most expensive, priced at a minimum of AUD$ 850 in most clinics. However, this figure isn’t conclusive since anaesthetists must assess a patient’s case first, identifying the ideal procedure, the required treatment time, and the patient’s sedation level requirement.

IV sedation aside, the average dental sedation cost across the country runs from AUD$600 to AUD$800, with longer-lasting sedation times costing the highest. Some dentists charge AUD$200 and AUD$400 for inhaled sedation.

You may also check with your provider, as some private health insurance usually covers these procedures, especially if the patient is about to undergo complex and significant dental work.

Some Private Insurers May Cover Dental Sedation Costs

To some extent, insurers may consider covering a portion of your dental sedation services if it’s essential to accessing or completing specific procedures. For instance, patients with special needs and disabilities may require sedation for a root canal or a tooth extraction.

In some cases, insurers may also consider this extra service for patients undergoing complex dental procedures such as dental surgeries.

Options For Dental Sedation Payments

More often than not, insurance companies don’t cover dental sedation services. If you’re one of the many patients who aren’t eligible for either partial or full coverage, study these options:

  • Ask if your dentist or service provider offers a payment plan

Some dentists and sedation service providers have instalment schemes to help patients pay for costly dental services. Ask your practitioner or the clinic staff if they offer such an option.

  • Apply for third-party financing

Health financing companies may pay your dentist the total costs of dental services, including dental sedation, and you can pay them in monthly instalments. Note that this option will require you to pay additional charges, so choose a company that offers the best repayment terms.

The Bottomline

Private health insurance companies usually don’t cover dental sedation services, except in complex cases, including significant dental work and in patients with special needs. Sometimes, sedation is unnecessary, so it’s best to prepare by understanding your insurance policies and discussing payment terms with your dentist or service provider.