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Is Cosmetic Dentistry Covered by Your Insurance?

Aug 13, 2018
You probably already know that most dental insurance plans offer coverage for preventative services like x-rays and cleanings, but what about cosmetic dentistry?

You probably already know that most dental insurance plans offer coverage for preventative services like x-rays and cleanings, but what about cosmetic dentistry? The good news is many insurance companies cover various cosmetic procedures. As long as they meet simple requirements for coverage. Here’s what you should know about seeing a cosmetic dentist for cosmetic dental procedures.

What Is Cosmetic Dentistry?

Insurances cover a wide range of cosmetic dentistry. According to the ADA, potential cosmetic procedures can include:

  • Teeth whitening, or chemical treatment of the teeth to remove discoloration and stains
  • Porcelain crowns
  • Dental implants. Used to replace lost teeth and involve placing a titanium screw inside the jaw to serve as an anchor for a crown.
  • Braces
  • Invisalign
  • Veneers
  • Bonding
  • Bridges
  • Inlays and onlays
  • Gum contouring
  • Tooth shaping, which refers to changing the shape of the tooth through a filling to improve its appearance

A general or family dentist can perform many types of cosmetic procedures, but some of these procedures overlap into specialties like orthodontics. Dental prosthodontics is the only specialty the ADA recognizes for cosmetic dental procedures.

What Is the Purpose of the Dental Procedure?

With most dental insurance plans, the purpose of the cosmetic procedure will matter when it comes to coverage. Cosmetic only procedures like porcelain veneers and teeth whitening usually aren’t covered. Insurances likely cover procedures that improve your oral health and/or restore your tooth structure. Covered cosmetic procedures tend to be 50% covered.

For coverage of a cosmetic procedure, there usually must be an underlying medical benefit to the procedure in addition to the aesthetic benefit. While procedures like gum contouring and teeth whitening are virtually never covered by insurance, it can be possible to have crowns, bonding, and veneers covered in some cases.

Insurances cover bridges and crowns done to repair a crack or support a weak tooth. Crowns made of amalgam for the back of the mouth are more likely covered than porcelain crowns. While dental implants are usually not covered, some insurance plans cover the cost of sedation and bone grafting. Coverage of bonding is likely covered to fix a tooth that’s damaged.

Dental Insurance and Orthodontics

One of the most expensive cosmetic procedures for children and adults is braces. The cost for braces can range significantly based on the type. Traditional metal braces may cost $3,000 to $7,000 while Invisalign can cost $4,000 to $7,500. Most dental plans do not cover orthodontics for adults but they can offer partial coverage for children. It’s common for dental insurance plans to cover braces for children at 50% with a lifetime cap of $1,500.

Dental Coverage for Crowns and Bridges

Dental crowns and bridges are usually covered by dental insurance because they are used to support a weak tooth, repair damage to a tooth, and/or retain a normal bite and help with chewing. The standard dental insurance plan offers “100-80-50” coverage, which means 100% coverage for preventative and diagnostic care, 80% coverage for basic services like fillings, and 50% for major procedures like crowns.

While your plan likely covers 50% of the cost of a necessary crown, the material may matter. Coverage usually includes a porcelain crown for the front teeth. Typically, only amalgam crowns for the back teeth. Amalgam crowns are made of a metal alloy while porcelain crowns are longer-lasting and look just like real teeth.

Paying for Cosmetic Procedures

Paying for dental care can be challenging, especially when dental insurance does not cover a procedure. Whether you have no dental insurance, your plan does not cover your procedure, or you still have a high out-of-pocket cost after insurance, there are options to help you afford your treatment.

If you are considering a cosmetic procedure, we encourage you to contact your dental insurance provider to discuss coverage. Your local dentist can also help answer any questions you may have about paying for your cosmetic procedure. Schedule a consultation for a variety of cosmetic procedures like teeth whitening, dental implants, and crowns.

Trinity Dental Care offers a Membership Club Program starting at $20 per month. The program gives you access to affordable dental care. It includes preventative care and 20% of most other treatments. Also included, a variety of cosmetic procedures.

Trinity Dental Cares is located in Scottsdale, AZ & are here for all your dental needs. With a focus on family & cosmetic dentistry, we are happy to help you achieve a beautiful smile in our comfortable, safe & friendly environment.