Will dental insurance cover crown replacement?

Dental insurance does cover crowns, but only when they are medically necessary. Coverage for a crown is usually 50% of the cost of the procedure, and the patient is responsible for the rest. Waiting periods of up to one to two years after purchasing dental insurance may apply to your crown coverage. In general, dental insurance will cover procedures such as routine cleanings, fillings, and x-rays.

Porcelain crowns are also often covered because, although they have cosmetic functions, crowns are necessary to maintain good dental health. They can help repair a cracked tooth or support a weak tooth. If the porcelain crown motif is purely cosmetic, it may not be covered. Although dental insurance companies claim to cover major reconstructive dental care, such as removable partial dentures, dentures, bridges and implants to replace missing teeth.

Note the small clause “pre-existing conditions. What this means is that if a tooth was missing before you were covered, the insurance company will NOT pay claims for replacing it. I've had many patients disappointed because they had dreams and aspirations that dental insurance companies would ultimately help them regain their confidence and a healthy smile, only to find that they hadn't read the “pre-existing condition clause.” Typically, dental insurance is offered annually and must be renewed at the end of the year to maintain coverage. Another type of dental crown involves the use of a metal structure with a layer of porcelain that matches the color of the surrounding teeth.

Some dentists may offer a slightly discounted rate for customers who don't have dental insurance. Dental plans tend to cover the cost of dental crowns only in cases where crowns are medically necessary. As an important service, dental plans generally cover crowns at 50% of what the company considers the “usual, customary and reasonable (UCR) rate. If you still want to continue improving your smile with crowns, there are many options for patients to receive cheaper dental care, but with the same materials.

This combination of 100% covered preventive services and lower out-of-pocket costs makes dental insurance a valuable benefit. While dental coverage will not include receiving a crown for cosmetic purposes, it will cover part of the cost to improve your oral health (such as a broken tooth). Unfortunately, not everyone can have their dental procedures covered by insurance plans and have to pay high out-of-pocket costs. If you have requested one to replace a tooth that is not satisfied with its appearance, the plan will most likely not cover the cost.

Patients in and around the Santa Clarita area who are looking for a quality dentist in the community can connect with Healthy Smiles Dental to schedule a free consultation appointment. Dental plans can cover a wide range of dental care procedures, especially those that are absolutely necessary to help you maintain your oral health. Without dental insurance coverage, the patient will have to pay 100% of the total cost of the crown installation. If you need a porcelain crown, one of the main factors in your decision may be the cost and whether it is covered by dental insurance.

Insurance companies often group dental procedures into general categories (usually Preventive, Basic, and Major).

Benjamín Gonçalves
Benjamín Gonçalves

Certified web maven. Freelance writer. Award-winning travel evangelist. Infuriatingly humble internet buff. Certified bacon practitioner.

Leave Reply

All fileds with * are required