Is LANAP Covered By Insurance

Is LANAP covered by insurance? This is an important question asked by many patients seeking effective gum disease treatment. LANAP is quite effective in healing and restoring gum health, which makes it an appealing option for those with periodontal issues. It is complex to understand if LANAP is covered by dental insurance. 

Let us explore the specifics of LANAP coverage, examine the factors that influence insurance decisions, and guide how to make the treatment financially accessible.

What Is LANAP?

LANAP, or Laser-Assisted New Attachment Procedure, is an advanced dental treatment that treats gum disease, also known as periodontal disease. This procedure uses laser technology to target and kill harmful bacteria and infected tissue in the gums, promoting healing and regeneration. 

Explanation of the Procedure and Its Purpose

During the LANAP procedure, a dentist or periodontist uses a specialized laser to remove diseased gum tissue without affecting the surrounding healthy tissue. The laser targets the infected areas, kills bacteria, and stimulates the body’s natural healing response. After the infected tissue is removed, the laser helps to seal the gums, reducing bleeding and promoting faster recovery. This minimally invasive approach provides a more comfortable experience with less downtime than conventional surgical techniques.

Benefits of LANAP Compared to Traditional Periodontal Treatments

1. Minimally Invasive: LANAP is less invasive than traditional surgery, meaning less tissue trauma and reduced discomfort during and after the procedure.
2. Faster Recovery: Patients typically experience a shorter recovery time with LANAP, allowing them to return to their daily activities sooner.
3. Reduced Pain: The use of laser technology minimizes the need for anesthesia, and many patients report less pain compared to conventional methods.
4. Preservation of Healthy Tissue: LANAP specifically targets infected tissue, preserving more of the surrounding healthy gum tissue, which contributes to better overall outcomes.
5. Long-lasting Results: LANAP has been shown to effectively control gum disease, leading to improved gum health and stability over time.

What Factors Influence Insurance Coverage For LANAP?

• Medical Necessity

Insurance companies often check if a treatment is medically necessary. If your dentist proves that LANAP is important for treating gum disease and avoiding more serious issues, insurance may cover it.

• Your Insurance Plan

Some insurance plans may cover LANAP as part of periodontal (gum) treatment, while others may not. You need to check your specific plan to see if LANAP falls under covered procedures.

• Procedure Coding

Insurance uses specific codes to classify treatments. LANAP might be grouped under general gum treatment, which could be covered, or it might be seen as a special or advanced procedure, which might not be. How it’s coded can affect coverage.

• Prior Authorization

Sometimes, your insurance company will want approval before LANAP is done. Your dentist may need to send in paperwork explaining why LANAP is needed. Without this prior approval, your insurance might refuse to pay for the procedure.

• In-Network Providers

Insurance usually pays more if you see a dentist within their network. If your dentist is out-of-network, LANAP could cost you more or might not be covered at all.

Is LANAP Covered By Insurance?

Generally, dental insurance covers traditional periodontal treatments like scaling and root planing, but LANAP is a relatively new procedure. It is considered an advanced or alternative treatment due to its use of laser technology, and this factor alone can lead to variability in coverage. Over the years, insurance companies have slowly started recognizing LANAP as a legitimate treatment for gum disease, but coverage is still not guaranteed across the board.

Reasons Why LANAP May or May Not Be Covered by Insurance

Factors That Support Coverage

Medical Necessity:

If LANAP is recommended to treat advanced gum disease that threatens oral health, insurance is more likely to cover it. Proper documentation from the dentist proving that the procedure is essential can help justify coverage.

Periodontal Treatment Benefits:

Some dental plans include coverage for gum disease treatments. If LANAP falls under the umbrella of periodontal surgery or treatment, it may be partially or fully covered.

In-Network Providers:

Insurance companies are more likely to cover LANAP when performed by in-network dentists, as it helps manage costs.

Common Reasons for Non-Coverage

Elective or Experimental Classification:

Many insurers view LANAP as an advanced or experimental procedure compared to traditional treatments, leading to non-coverage.

Plan Limitations:

Basic or lower-cost dental plans may not include advanced treatments like LANAP, covering only essential or traditional periodontal procedures.

Lack of Prior Authorization:

Without prior authorization from the insurance company, LANAP may not be covered even if it’s otherwise eligible.

How To Determine If LANAP Is Covered By Insurance?

Review Your Policy:

Check the details of your dental insurance plan, specifically the section on periodontal treatments, to see if LANAP is mentioned or if laser therapies are covered.

Contact Your Insurance Provider:

Speak directly with the insurance company to confirm whether LANAP is covered under your plan. Ask about any limitations, exclusions, or required pre-authorization.

Ask for Pre-Authorization:

Request your dentist to submit a pre-authorization for LANAP. This helps clarify coverage and potential out-of-pocket costs before undergoing the procedure.

Verify In-Network Providers:

Confirm if the dentist performing LANAP is in your insurance network, as this can affect both coverage and costs.

What Should You Do If LANAP Is Not Covered By Insurance?

Payment Plans:

Many dental offices provide payment plans to spread out the cost of LANAP over time.

Medical Credit Cards:

Services like CareCredit allow you to finance dental procedures, including LANAP, with manageable monthly payments.

Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA):

You can use these accounts to cover LANAP, helping to reduce the financial burden.

Is LANAP Covered by Insurance?

LANAP offers an advanced and less invasive option for treating gum disease; despite this, it may or may not be covered by an insurance provider. Coverage depends on factors like your insurance plan, the procedure’s classification, and its medical necessity. To fully understand your options, it’s important to review your insurance policy, consult with your provider, and discuss financing alternatives with your dentist if needed.

Book Your Consultation Today at Clarksburg Dental Center

At Clarksburg Dental Center in Germantown, MD, we’re here to guide you through your LANAP treatment and help you understand your insurance coverage options. Book your consultation today if you’re ready to explore your periodontal health and see if LANAP is right for you!

Call us now:

• New Patients Only: (301) 245-2217
• All Other Callers: (301) 515-5525

FAQs

Is LANAP covered by most dental insurance plans?

LANAP coverage varies depending on the insurance provider and the specifics of your plan. While some dental plans may cover it under periodontal treatment, others may classify it as elective or advanced, limiting coverage.

Are there alternatives to LANAP that might be covered by insurance?

Treatments like scaling and root planing or conventional gum surgery are often covered by insurance and may be effective alternatives to LANAP.

How much does LANAP cost per tooth?

It costs around $400 for a single tooth LANAP therapy.