What Does Your Insurance Cover?
The type of insurance you have will affect the extent of dental care cover. Medical insurance that includes dental benefits could be convenient but may have limitations. In contrast, a direct dental insurance plan offers flexibility and more coverage options. Here are the dental care procedures that insurance may cover:
- Preventative care: Includes routine office visits and professional dental cleaning.
- Basic Restorative care: For dental treatments like fillings and crowns.
- Endodontics: For root canals.
- Oral Surgery: Tooth extractions, tissue biopsy, drainage of bacterial infections, and placement of dental implants.
- Orthodontics: Palatal expanders, braces, aligners, and retainers.
- Periodontics: Scaling, root planing, gum grafting, periodontal surgery, and placement of implants (if certified for implant placement).
- Prosthodontics: Dentures, bridges, and dental implants
According to the National Association of Dental Implants, these procedures are categorized into three groups of coverage for payment purposes: preventative care, basic procedures, and major procedures. Generally, insurance plans will cover 100% of preventative care. Basic dental treatments like tooth extractions, fillings, root canals, and gum disease treatment may be covered at a lower rate, approximately 80% or less. Dental crowns, dentures, and dental implants are major procedures that tend to be covered at the lowest percentage, such as 50%. It is common for dental insurance plans to have a waiting period, typically a year or less, before covering major procedures like dental implants. Be sure to speak to your insurance provider to find out about the waiting period and if they cover major dental procedures such as implants.