Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Dental Insurance – Is Your Procedure Covered?

Cosmetic dentistry treatments are pricey. And how to pay for them (or at least significantly reduce out-of-pocket) expenses is a primary concern for many.

A lot of people look toward dental insurance as a way to try to cover some or all of their costs. But does dental insurance help with cosmetic procedures?

Unfortunately there’s not a definite “yes” or “no” answer to that question. That said, when it comes to cosmetic dentistry procedures, the answer is more likely to be “no” than “yes”.

This is because dental insurance plans tend to cover regular cleanings, treatments used to help prevent oral diseases and/or negatively impact your health.

Cosmetic dentistry procedures are mostly done for looks. The aim is just about improving the way your teeth and mouth look. Which makes them elective procedures and insurance companies usually will not cover elective procedures like this.

Can Dental Insurance Help At All?

Not all hope is lost, however. There’s at least a chance you can get part of cosmetic dentistry procedure covered by your insurance company. It mostly comes down to what kind of treatment you want to get, why you’re getting the treatment and your dental insurance company/policy.

How To Figure Out What’s Covered and What’s Not

Step 1 is to look at your specific dental insurance policy. Yes, it may very well be painful reading the fine print of an insurance policy. But it’s well worth the effort.

If your dental insurance policy is through your employer, check with HR to see if the policy covers any cosmetic procedures. If you already have a dentist that you want to perform the cosmetic treatment for you, you can also check with their staff. They should have a good understanding of the different insurance plans and what is and isn’t covered.

You can also submit a pre-determination to your insurance plan to see if they cover your desired treatments.

If you have a policy that doesn’t have cosmetic benefits then, chances are you’re out of luck. At that point, you’re only option to get insurance to cover part of your procedure is to try to find a different policy that’s affordable and does cover cosmetic dentistry treatments.

Just understand that pretty much any dental insurance plan that includes cosmetic benefits will place limits on cosmetic coverage.

General Rules of Thumb For What Dental Insurance Will Cover

Every policy is different. That said, here are some general rules of thumb around what cosmetic procedures are covered by dental insurance and which ones aren’t…

The following are almost never covered by dental insurance:

  1. Tooth whitening or bleaching
  2. Correcting a space between teeth

For pretty much any other kind of treatment, it depends.

Veneers

Veneers typically aren’t covered by dental insurance. That said, insurance companies may cover part of their costs in certain situations. These situations would be ones in which there is some sort of underlying medical reason why your cosmetic dentist says you need to get veneers.

Defective Filling

Insurance may also pay for part of a cosmetic procedure needed when a defective filling in a front tooth needs to be replaced. Yes, there are cosmetic benefits here. However, it may also help remove the underlying decay and improve your oral health.

Discolored Tooth

Insurance may also pick up at least part of a tab when a tooth is discolored or weakened because or large restorations. In this case the crown used to restore and strengthen the tooth could be covered.

At the end of the dental there’s no dental insurance policy (that we’re aware of anyway) that covers 100% of the cost of all cosmetic dentistry procedures.

The best thing you can do is talk to your employer, insurance company and/or dentist to see about getting some of the cost of your procedure paid for by insurance. If you can’t, then we’d recommend looking into payment plans, financing and/or cheaper alternatives to get the smile of your dreams.