You’ve heard over and over again that dental insurance does not cover cosmetic dental treatments. Since they are elective procedures that are not required to achieve better oral health, many companies will not pay for these kinds of services. However, what you may not realize is that there are special circumstances that can occur – ones that can have you receiving partial coverage for aesthetic-based care. Keep reading to discover when your dental insurance company will make the exception and offer some financial reprieve.
Why Do Dental Insurance Companies Not Generally Pay for Cosmetic Care?
It all comes down to whether a procedure or service is “medically necessary.” Does it improve a person’s oral health? If so, you’ll likely receive some form of coverage. However, if it is only used to improve the appearance of a person’s smile, this is considered “elective,” leaving you to find another way to pay.
Dental insurance companies generally offer coverage for preventive and restorative dentistry because of how these specific services (i.e., dental checkups and cleanings, X-rays, gum disease treatment, dental fillings, dental crowns, root canal treatment, etc.) are used to address a specific problem that can have a negative effect on a person’s oral and overall health.
Which Cosmetic Situations Are Considered Exceptions for Insurance Coverage?
There are, however, instances in which a dental insurance company will agree to pay for some portion of a cosmetic dental service. It must be documented in a way, though, that the insurance company sees the “need” for treatment to improve a person’s smile and oral health. This is why it’s important to have a trusted member of your dental team complete this paperwork.
Some of the exceptions that dental insurance companies will make when it comes to covering cosmetic treatments include:
- Tooth-colored fillings or metal-free dental crowns are considered restorative and cosmetic treatments. Not only do they work to protect and improve the health of your smile, but they also create a more aesthetically pleasing appearance.
- A single veneer or cosmetic bonding can be covered if you have an irregularity that is not severe enough for a dental crown but requires some form of coverage/protection against further damage.
In general, if you’re looking to simply improve the look of your smile, you’ll need to seek alternative financial options to help pay for treatment. However, if your situation warrants a more restorative approach but provides a more pleasing aesthetic solution, it’s in your best interest to see if you can save more by filing a claim with your dental insurance.
About the Author
Dr. Aaron Swingdorf is a cosmetic dentist who delivers exceptional results in a state-of-the-art facility. Located in Chaska, he helps patients who desire more aesthetically pleasing smiles. With cosmetic dentistry, he can build and restore smiles to their natural beauty using an array of options (i.e., veneers, teeth whitening, metal-free restorations, etc.). If you want to boost your appearance while also improving the health of your smile, contact us at (952) 448-4151 or visit our website to find out how we can help you get the most out of your dental insurance benefits.
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