If you’ve been looking at cosmetic dental treatments, you might be starting to worry. Maybe you’d like the confidence that comes with a dazzling smile, or maybe you need a practical tooth-colored filling. Either way, that price tag can be intimidating!
When it comes to cosmetic dentistry, deciphering what your dental insurance will cover can be complicated. While every plan is different, there are some general rules that can help you better understand your dental insurance coverage. Keep reading to learn more!
The Dental Insurance Break-Down
Your dental insurance coverage has many variables that will make it unique to you. Deductibles, annuals, and exclusions to name just a few. That said, many dental insurance companies follow this general pattern:
- 80% – 100% coverage provided for preventative care
- 50% – 80% coverage provided for minor restorative treatments
- 50% or less coverage provided for other major services
The big takeaway here is that dental insurance loves to emphasize preventative care services. Another thing you’ll want to note is that if your treatment is completely optional, dental insurance will likely not be willing to offer any coverage.
How Do I Know if My Cosmetic Treatment is “Optional”?
There are three categories your dental treatment could fall under:
- Preventative care includes services such as checkups, cleanings, and X-rays. They help prevent you from needing dental treatments in the first place.
- Medically necessary treatments are vital for your oral health. Depending on the situation, this can include restorative options like crowns, fillings, and dental implants.
- Elective or optional services are treatments you could live without. These most often include services like teeth whitening and dental veneers.
There can be some overlap between medically necessary treatments and cosmetic dentistry, so it’s understandable to be confused. For example, clear aligners like Invisalign are considered a cosmetic treatment because they improve aesthetics by straightening teeth. However, straightening teeth can qualify as medically necessary, which earns it some insurance coverage.
Basically, if you’re getting a purely cosmetic treatment just for the fun of it, your dental insurance will likely consider it an optional service and withhold coverage. But if you need something like a crown repair and decide to give it an aesthetic update, your insurance might cover at least part of the cost.
Your Dentist Can Help You Budget!
It’s nice to have an overview of what your dental insurance might cover, but maybe you need a more detailed estimate before you can commit to your dream smile. Fortunately, your dental office works with dental insurance every day! They can take a closer look at your coverage and help you maximize your benefits.
Should your insurance not offer any coverage for the cosmetic service you’re interested in, you might be able to enroll in third-party financing like CareCredit to help break up the cost. Don’t hesitate to ask your dentist about affordability during your consultation!
About the Dentist
Dr. Navkiran Dhillon believes in the transformative power of cosmetic dentistry. She loves helping patients reach their smile goals and doesn’t want cost to come between you and an empowering treatment. If you have questions about your dental insurance coverage or would like to learn more about your affordable financing options, call her office at 413-967-7140. For a list of in-network providers, explore her website.