Lee Dental & Facial: Angela Lee

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    Cosmetic dentistry treatments are not cheap. So the question of how to pay for them is probably a major concern for many.

    One option that people will look to is insurance. Especially if you have a dental insurance plan, you may be wondering if your cosmetic dental service will be covered by your provider.

    There is no definite answer we can give you. However, for cosmetic services, the answer is more likely to be “no” than “yes”.

    Here’s why… dental insurance generally cover procedures that prevent disease, maintain oral hygiene, and treat dental problems that negatively impact your health. Most cosmetic dentistry procedures, however, focus on improving the appearance of your teeth and mouth. These are elective procedures and, as such, most insurance carriers will not cover them.

    When Dental Insurance Can Help

    That said, it is possible to get at least some of your cosmetic procedures covered by your insurance company. Whether or not you can get partial coverage depends on the treatment, the reason for getting the treatment and your insurance company.

    What To Check For

    The first thing to do if you’re considering a cosmetic procedure is look at your dental insurance policy and see if you have cosmetic coverage. If you have your dental insurance through your employer, contact the benefits department to ask if your policy includes cosmetic coverage. Or, if you’ve already selected a dentist to perform your procedure, have their staff check your benefits for you.

    Another option is to submit a pre-determination to your insurance plan to see if they cover your desired treatments.

    If you don’t have cosmetic benefits in your policy, then you’re pretty much out of luck. Though you could look around to see if you can find an affordable policy that does include cosmetic benefits.

    If you do have cosmetic benefits in your policy, there almost surely will be some limitations in coverage.

    General Rules of Thumb

    Here are some general rules of thumb about coverage, however, you’ll have to do your own research to get the specifics for your situation…

    There are a few cosmetic procedures that are almost never covered by insurance…

    Tooth whitening or bleaching
    Correcting a space between teeth
    For other treatments, again, it depends.

    For example, veneers are usually not covered by insurance. However, there are situations where insurance companies will cover part of the cost for veneers and bonding. Yes, these procedures help reshape, align and change the color of your teeth – which is all cosmetic. But if there was some underlying medical reason why the veneers/bonding was needed, that’s a situation where your insurance company may pick up part of the cost.

    Other Examples

    A few other examples where cosmetic work may be covered:

    A defective filling in a front tooth needs to be replaced. This will provide cosmetic benefits to your teeth by removing the discolored restorations along with the underlying decay.

    A tooth that was discolored and/or weakened due to large restorations that will require a crown (cap) to restore and strengthen the tooth.

    Bottom line, there is no insurance policy we know of that will cover 100% of the cost of all cosmetic dentistry procedures. So talk to your dentist and insurance company to see if you can get part of your procedure covered. And then, based on what you find out, see what other financing options, payment plans and/or less expensive procedures may be available to you.

    in Dental Insurance