Why Isn’t Arestin Covered by Insurance? Unraveling the Dental Medication Insurance Mystery

When it comes to dental health, many of us rely on insurance to cover our expenses. However, you may have discovered that some dental treatments and medications, such as Arestin, aren’t always covered. In this article, we will delve into the reasons why Arestin, a medication used for gum disease treatment, may not be covered by insurance.

Understanding Dental Insurance

Types of Dental Insurance

Dental insurance plans can vary widely, but they generally fall into two categories: dental health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Understanding your plan is crucial when assessing coverage for specific treatments like Arestin.

Coverage Variations

Dental insurance plans can differ significantly in terms of coverage. While some plans may cover a wide range of treatments and medications, others may have limitations or exclusions. It’s essential to review your policy carefully.

Why Arestin May Not Be Covered

Medication Classification

Arestin is an antibiotic medication used to treat periodontal disease by reducing bacteria in the pockets between your teeth and gums. Some insurance plans may not cover medications, categorizing them as elective treatments.

Limited Proven Effectiveness

Another reason for limited coverage could be concerns about the proven effectiveness of Arestin. Insurance providers often evaluate whether a medication or treatment has substantial clinical evidence supporting its use before including it in coverage.

Alternative Treatments

Insurance companies may prefer to cover alternative treatments for gum disease, such as scaling and root planing. These procedures are considered standard care and may be the first choice for insurance coverage.

Options for Coverage

Out-of-Pocket Payments

If your insurance doesn’t cover Arestin, you may need to pay for it out of pocket. However, it’s essential to consult with your dentist and insurance provider to explore alternative treatments that may be covered.

Dental Discount Plans

Some individuals opt for dental discount plans, which can provide reduced rates on dental treatments, including medications like Arestin. These plans may offer more flexibility in covering specific treatments.


While Arestin is a valuable medication for treating gum disease, its coverage under dental insurance plans can be limited. Understanding your insurance policy’s terms and limitations is crucial to managing your dental health effectively. If Arestin isn’t covered, discuss alternative treatments and payment options with your dentist and insurance provider.


  1. Why doesn’t my dental insurance cover Arestin?
    Dental insurance plans vary in coverage, and some may not include medications like Arestin due to their classification as elective treatments.
  2. Is Arestin an effective treatment for gum disease?
    Arestin has been shown to be effective in treating periodontal disease by reducing bacterial infection in gum pockets. However, insurance providers may have varying criteria for covering it.
  3. What should I do if Arestin isn’t covered by my insurance?
    If Arestin isn’t covered, consult with your dentist and insurance provider to explore alternative treatments that may be covered or discuss payment options.
  4. Are there dental discount plans that can help reduce the cost of Arestin?
    Yes, some dental discount plans offer reduced rates on dental treatments, including medications like Arestin. These plans can be an option if your insurance doesn’t cover the medication.
  5. Can I appeal to my insurance company for Arestin coverage?
    You can inquire with your insurance provider about the possibility of coverage for Arestin. They may provide information on the appeals process or alternative treatments.

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