dental care add-on
Start
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condensing dental coverage
Dental coverage is being streamlined by removing routine dental cleanings from the Preventative Plus Care add-on and consolidating all dental-related coverage under the new Dental Care add-on. This add-on will function similiarly to the current Dental Illness add-on but with several key enhancements:
- The Dental Care add-on will have a $1,000 annual limit
- The coinsurance will be applied but claims are not subject to the annual deductible
- Coverage of pre-existing dental-related conditions will be allowed
- Dental cleanings will be eligible for coverage regardless of dental disease grade
- The Dental Care add-on is not subject to any waiting period. That means coverage is effective the day of the policy effective date.
Next
Click the headphones for an audio reading of this page
Dental claim processing guidelines
Since the Dental Care add-on covers all dental-related conditions, including if the pet has a pre-existing dental illness, and there are no waiting periods, dental illness-related claims have been exponentially simplified.
- We do not need to obtain medical records to determine the *disease type or if it's eligible for coverage. There are no coverage restrictions.
- We do not need to ensure that the policyholder followed **timely recommendations to have dental care performed.
In short, dental illness claims with the Dental Care add-on are eligible for coverage as long as they within their policy period.
**Timely Recs - More Information
Important
*Disease Type - More Information
Next
Click the headphones for an audio reading of this page
Rapid fire Q&A
Q: If the pet has pre-existing resorptive lesions, will we really cover their treatment (dental cleaning, extractions, etc.) with the Dental Care add-on? A: Yes! It would be covered up until the add-on limit of $1,000. Q: If the vet recommended a dental cleaning 12 months ago and now the pet has significant dental disease, will that be covered if they have the Dental Care add-on? Or would it be denied due to adequate care/preventable conditions? A: We will not assess whether the policyholder followed their veterinarian’s recommendations. As long as the condition is eligible under the Dental Care add-on, both the dental cleaning and any related treatment for the dental illness would be covered, regardless of how much time has passed since the cleaning was recommended. Q: When do medical records need to be collected for dental-related claims? A: If they have the Dental Care add-on, never. Q: When performing a medical record review (MRR), do we need to list periodontal disease in the medical timeline and pre-existing conditions table? A: Yes. Since we will still be following the historal claim processing guidelines for the Dental Illness and Preventative Plus add-ons, periodontal disease and other dental-related illnesses must still be documented if found during an MRR.
End
Click the headphones for an audio reading of this page
Timely Recommedations
Due to us covering a dental-related illness regardless if it's pre-existing or not, whether or not a policyholder followed timely recommendations to receive treatment becomes a moot point. As such, we will not be checking medical records to ensure the policyholder followed recommendations to have a dental done within a certain amount of time in order for the claim to be eligible for coverage.
Disease Type
Click the headphones for an audio reading of this page
What is classified as a dental illness has not changed. This still includes, but is not limited to:
- Periodontal disease (dental disease)
- Gingivitis, plaque, tartar
- Malocclusion
- Resorptive lesions (FORLs)
- Stomatitis
- CUPs
- Base narrow canines
- Carious lesions (cavities)
Teeth that are fractured due to an accident are still eligible for coverage under the base A&I policy. Confirmed immune-mediated stomatitis is still eligible for coverage under the base A&I policy.
Click the headphones for an audio reading of this page
Important
The claim processing guidelines in this course are ONLY for the new Dental Care add-on. If the pet has the Dental Illness add-on or the Preventative Plus add-on, the historical claim processing guidelines must still be adhered to. These old add-ons will be eventually phased out completely, but it will take some time as the Dental Care add-on is rolled out to each state and the other add-ons sunset. When in doubt, please refer back to Guru.
OB Dental Care Add-On Updates
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Created on March 21, 2026
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Transcript
dental care add-on
Start
Click the headphones for an audio reading of this page
condensing dental coverage
Dental coverage is being streamlined by removing routine dental cleanings from the Preventative Plus Care add-on and consolidating all dental-related coverage under the new Dental Care add-on. This add-on will function similiarly to the current Dental Illness add-on but with several key enhancements:
Next
Click the headphones for an audio reading of this page
Dental claim processing guidelines
Since the Dental Care add-on covers all dental-related conditions, including if the pet has a pre-existing dental illness, and there are no waiting periods, dental illness-related claims have been exponentially simplified.
- We do not need to obtain medical records to determine the *disease type or if it's eligible for coverage. There are no coverage restrictions.
- We do not need to ensure that the policyholder followed **timely recommendations to have dental care performed.
In short, dental illness claims with the Dental Care add-on are eligible for coverage as long as they within their policy period.**Timely Recs - More Information
Important
*Disease Type - More Information
Next
Click the headphones for an audio reading of this page
Rapid fire Q&A
Q: If the pet has pre-existing resorptive lesions, will we really cover their treatment (dental cleaning, extractions, etc.) with the Dental Care add-on? A: Yes! It would be covered up until the add-on limit of $1,000. Q: If the vet recommended a dental cleaning 12 months ago and now the pet has significant dental disease, will that be covered if they have the Dental Care add-on? Or would it be denied due to adequate care/preventable conditions? A: We will not assess whether the policyholder followed their veterinarian’s recommendations. As long as the condition is eligible under the Dental Care add-on, both the dental cleaning and any related treatment for the dental illness would be covered, regardless of how much time has passed since the cleaning was recommended. Q: When do medical records need to be collected for dental-related claims? A: If they have the Dental Care add-on, never. Q: When performing a medical record review (MRR), do we need to list periodontal disease in the medical timeline and pre-existing conditions table? A: Yes. Since we will still be following the historal claim processing guidelines for the Dental Illness and Preventative Plus add-ons, periodontal disease and other dental-related illnesses must still be documented if found during an MRR.
End
Click the headphones for an audio reading of this page
Timely Recommedations
Due to us covering a dental-related illness regardless if it's pre-existing or not, whether or not a policyholder followed timely recommendations to receive treatment becomes a moot point. As such, we will not be checking medical records to ensure the policyholder followed recommendations to have a dental done within a certain amount of time in order for the claim to be eligible for coverage.
Disease Type
Click the headphones for an audio reading of this page
What is classified as a dental illness has not changed. This still includes, but is not limited to:
- Periodontal disease (dental disease)
- Gingivitis, plaque, tartar
- Malocclusion
- Resorptive lesions (FORLs)
- Stomatitis
- CUPs
- Base narrow canines
- Carious lesions (cavities)
Teeth that are fractured due to an accident are still eligible for coverage under the base A&I policy. Confirmed immune-mediated stomatitis is still eligible for coverage under the base A&I policy.Click the headphones for an audio reading of this page
Important
The claim processing guidelines in this course are ONLY for the new Dental Care add-on. If the pet has the Dental Illness add-on or the Preventative Plus add-on, the historical claim processing guidelines must still be adhered to. These old add-ons will be eventually phased out completely, but it will take some time as the Dental Care add-on is rolled out to each state and the other add-ons sunset. When in doubt, please refer back to Guru.