Does Insurance Cover Cosmetic Dentistry?

You’ve been considering a smile makeover, but one of your friends recently had several cosmetic dental procedures and told you that everything had to be paid for out of pocket. Is it possible to use your insurance benefits to cover your cosmetic dentistry treatment?

Understanding what differentiates your procedures from “elective” and “restorative” is the key differentiator.

Some Restorative Treatments are Cosmetic Dentistry

Let’s start with restorative dental treatments, which are almost always covered under your dental insurance. Restorations include things like fillings and crowns. It can also include dental implant therapy, depending on the specifics of your plan.

Restorations can be made in a manner where they are aesthetically pleasing, thus making up a crucial part of your smile makeover.

For example, white (composite) fillings and porcelain dental crowns protect and restore your teeth. But they’re also made using cosmetically pleasing materials that enhance the appearance of your tooth during the process. Regardless, they’re an essential procedure used to achieve a better level of oral health.

When your dentist uses white restorations due to physical damage to your teeth, you have a better chance of them being covered by your dental insurance.

When Treatments are “Elective”

An elective dental procedure is one that you choose to have completed, even if you don’t need it for health purposes. For example, if your teeth are free of decay or disease, but you don’t like the way they look, having them enhanced would be an elective procedure.

Dental insurance usually does not cover elective types of dental procedures such as cosmetic dentistry. Some common examples would include cosmetic veneers or teeth whitening.

There will, of course, always be exceptions to the rule. Perhaps you have a type of irregularity on a front tooth that needs to be repaired, but a dental crown will be too aggressive to the rest of the tooth structure. A veneer or cosmetic bonding would be less invasive and serve as a restorative-type procedure. Your dentist will likely have to submit case notes, photographs, and X-rays to the dental insurance company to convince them to pay for the treatment.

A Combination of Treatments

Every smile makeover is unique. Your dentist will evaluate your needs on a comprehensive and tooth-by-tooth basis. In some situations, a variety of restorative and elective treatments are used to achieve an overall goal. If you need to whiten your teeth before replacing a single porcelain crown (crowns can’t be whitened after they’re placed, so it’s best to start with a lighter color from the start) you would have to pay for the whitening out of pocket, before filing the crown against your insurance benefits.

As part of your cosmetic dentistry plan, your dentist will provide a variety of options and a detailed breakdown as to what’s covered (or not) by your benefit package.

In most cases, you can easily finance the portion of your treatment that isn’t covered by insurance, making it more affordable. If your insurance pays more than you expect, you’re left with a lower out-of-pocket amount.

Talk to your Kois Trained Dentist to find out which types of cosmetic restorative treatments are covered by your insurance.