Patients always want to get the most out of their dental insurance coverage. This is a completely reasonable expectation, but it can sometimes be a little tough to navigate what is and what is not covered by your dental insurance. This is especially true when it comes to cosmetic dentistry procedures.
The short answer is that most dental insurance will not cover cosmetic dentistry procedures. There are, however, some exceptions. To understand these exceptions, we should go over the difference between elective and restorative dental procedures.
An elective procedure involves dental work that is not necessary for medical reasons. Some examples of elective procedures include teeth whitening or correcting a congenital tooth gap. A restorative procedure is necessary for medical reasons. Some examples of restorative procedures include repairing a tooth broken by an injury, or extracting a diseased tooth.
Many dental procedures have both an elective and a restorative component. What if your tooth is broken by an injury, but it requires a cosmetic dental crown to fully repair it? In cases like this, your dental insurance might cover some or all of the cost of the procedure (minus any applicable deductibles), even if your insurance would not normally cover the cosmetic component of the procedure. It’s quite common for “cosmetic” procedures to have a medically-necessary component, so don’t pass up on a necessary cosmetic dentistry procedure just because you think your insurance might not cover it.
For the most definitive answer about whether or not your insurance will cover a cosmetic dentistry procedure, contact your insurance provider. Every provider and policy is different, so there is no single correct answer for all insurance and procedures. Call the customer service number listed on your dental insurance card and a representative should be able to give you a definitive answer based on your specific insurance coverage.