Delta Dental Coverage For Root Canal And The Cost

Most commonly, delta dental will cover root canals at 80% which means you have a 20% copayment. Based on a 20% copay, the average cost of a root canal with delta dental will be $111.60 out of pocket. All of this is based on seeing an in-network dentist.

However, those numbers may differ from individual to individual because everyone’s insurance plan is somewhat different. Your specific coverage percentage may be different.

Let us explain what all of that means by breaking down the calculations. We’ll also talk about exceptions and other factors which may influence the cost of your treatment.

How much root canal coverage with delta dental?

The most common root canal coverage with delta dental is 80% and that is based on what we see with our patients. That 80 percent figure is based on the hundreds of delta dental insurance plans that we have on record with our clinical practice.

Ultimately how that affects you is that you’d be responsible for the 20% that is not covered by delta. That 20% is what is referred to as your copayment for the procedure.

We’ve attached an example of a coverage breakdown of one of our patients with delta dental above. We’ve highlighted in the image that endodontic patient payment is 20%. This particular example is just to show you that the root canal coverage is at 80%.

Exceptions – when the coverage may differ

We wish to emphasize that the most common root canal coverage is at 80% with delta which means that it can be different. Depending on your particular insurance plan, it could be higher or it could be lower.

We’ve included an example in the image above where the patient is only responsible for 15% of endodontic procedures. That means the root canal coverage for this patient is 85% with a 15% copay. In other words, this example has more coverage than the average delta plan that we typically see.

This just goes to show that the coverage may differ depending on your plan. Usually when you were signing up for the insurance there were probably options for low, basic, and high plans. The different tiers denotes greater or lesser coverage for the different dental procedures.

How much does a root canal cost with delta dental?

The average cost of a root canal with delta dental insurance is $110.60 if you have 80% coverage. The $110.60 is essentially the 20% copay that you would have to pay prior to receiving treatment. Your insurance will cover the other 80% which would be $446.40 .

However the average cost we’ve given above does include the anterior teeth, premolars, and molar teeth. The average cost for root canals on these 3 types of teeth do differ, which we will breakdown in our table below.

Basically, the cost of your root canal will differ depending on which type of tooth needs it. The insurance plan will usually cover all types of procedures at 80% but there is a different dental billing code for each type of teeth.

• D3310 for anterior teeth (Canines, lateral incisors, central incisors).
• D3320 for premolar teeth (first and second premolars).
• D3330 for molar teeth (first, second, and third molars).

If you wanted a closer estimate, you should use our table above instead of the general total average.

Factors affecting total cost

Despite the listed coverage percentage there are other factors which may make your root canal cost more or less with delta dental. If you have one of these, your final copayment may be different.

Factors influencing cost:

• Annual deductible
• Annual maximum
• Provider network status

Annual deductible

Most dental insurances have an annual deductible which must be paid prior to benefits being disbursed. In other words, the deductible needs to be paid first or met before the insurance will start covering services.

The most common deductible which we see from our delta dental patients is $50. However we’ve also seen as low as $25 and as high as $100. The amount varies and depends on your insurance plan. Therefore if you have a deductible, it will add to the cost of your root canal.

Annual maximum

Every insurance plan has an annual maximum for the benefits it will pay out each year. If you have a high maximum it will cover what it says it will but if you have a low maximum, it may not cover everything.

Example:

• If you have a $2000 annual maximum, the 80% coverage for a root canal will cover the full insurance portion. You’d be responsible for the 20% copay.
• If you have a $250 annual maximum, despite having 80% coverage for the root canal, your insurance will only cover $250. Your copayment would be more than the $110.60 because you’d actually be responsible for $308 instead.

The example above is to show you how having a low maximum can increase your copay.

Provider network status

The network status of your dentist plays a large role in the cost of your crown. Everything that we’ve discussed above only applies to a dentist that is in-network with delta dental.

If the dentist that you’re seeing is out of network, none of the above would apply. The average cost of the root canal would be completely different from all of the calculations above. You’d actually be responsible for the difference between what delta would pay and your dentist’s private fees.

How to decrease the cost of a root canal

The only way to pay less for your endodontic procedure is by choosing an insurance plan with better coverage. You should try switching the plan to a “high tier” plan so more coverage. Sometimes these higher plans are also referred to as premium level plans.

Hopefully that helps you in your journey of having healthy teeth. Now you know how much it should all cost.