Yes, most dental insurance plans do cover root canal treatment, especially when it’s considered medically necessary. However, the exact amount covered can vary depending on your specific plan—some policies may pay a large percentage, while others might only cover part of the cost.

That said, approval isn’t always immediate. It can take 30 to 45 days for your dental insurance company to review and approve the treatment. Here’s how the process typically works:

Root Canal Approval Process:

Step 1: The dental office takes an X-ray of the affected tooth and sends it to your insurance provider.

Step 2: A dentist working for the insurance company reviews the X-ray and determines whether or not to approve the root canal.

Now, if you’re in New York, there’s an additional rule to be aware of, called the “8 Points of Contact Rule.” This regulation can impact whether your insurance company approves or denies coverage.

What is the 8 Points of Contact Rule?

In New York, if you have three adjacent teeth and only the middle tooth needs a root canal, your insurance company may deny the claim. Why? Because the other two surrounding teeth are still functional and provide what’s considered “8 points of contact” when chewing. From the insurance company’s perspective, that means the patient can still eat adequately without needing the root canal on the middle tooth—so they may classify it as not medically necessary.

Because of this rule, some medically needed root canals can still be denied by insurance in New York if they don’t meet this specific chewing functionality standard.