My medical insurance has different benefits if I choose a natural doctor and it forces me to pay more. I want to see a holistic dentist, so I’ve been looking through my benefits handbook. There isn’t anything listed. Does that mean I don’t have coverage for a holistic dentist at all?


Jeff in Georgia

Dear Jeff,

Dental insurances and medical insurances operate very differently. Although they both use procedure codes to determine which treatments are covered, and at which rates, there are seemingly a million medical codes. There are also 24 specialties recognized by the American Board of Medical Specialties (ABMS). If you add on top of that how some states recognize additional specialties, such as alternative doctors like naturopathic doctors or NDs, it makes medical billing an incredibly complex process. On the other hand, the American Dental Association (ADA) recognizes just nine specialties, and most insurance companies go by that.

In short, your medical benefits may differ depending on which kind of specialist you choose to see. However, holistic dentistry isn’t one of the ADA’s recognized specialties, so it’s quite likely that the dentist you’ll see is a general dentist, who has received specialized training and practices using holistic techniques. Although the mindset and many of the materials are different, the procedures, themselves, are typically coded the same.

Your dental insurance probably covers a holistic or natural dentist, but treats him as a general practitioner, so your benefits book won’t differentiate. If you want to be sure before you visit, find an office you like, give them a call, and provide them with your insurance information. More than likely, they’ll be glad to call on your behalf and find out which procedures are covered for you. If you’d rather do it yourself, you can ask the office which codes they typically bill on a first visit, and compare them with those in your benefits handbook. Throughout the course of your treatment, you may find that your insurance downgrades certain procedures. They may pay only the cost of a mercury filling, even if you’re getting a tooth-colored one. That’s standard for the industry, though, and doesn’t change based on what kind of provider you see.

This post is sponsored by Atlanta cosmetic dentist Flax Dental.