Does Dental Insurance Cover Chipped Teeth? #1

Studies show that 25% of adults chip a tooth at least once in their life. Since this could be anyone, we understand why you would ask “Does dental insurance cover chipped teeth?”, and we do have answers!

Dental Insurance does cover chipped teeth if it is medically necessary. This could be confusing for you, but no worries. In this article, we have broken this down. In addition, we will talk about the costs of chipped teeth coverage, alternatives to dental insurance, and lots more.

Thank us later!

Table of Contents

Does Dental Insurance Cover Chipped Teeth?

Yes, most dental insurance plans may provide coverage for chipped teeth under certain conditions including medical recommendations. However, repairs beyond the recommendation of a dentist are termed cosmetic and are considered unnecessary.

Your dental insurance plan may or may not cover chipped teeth based on some factors. These include; severity and impact, repair type, and type of insurance plan.

The Three Major Factors That Determine Whether Dental Insurance Will Cover Chipped Teeth

The following are the three key factors influencing dental insurance coverage for chipped teeth:

#1. Severity and Impact:

Minor chips are considered purely cosmetic as they do not impact oral health. Therefore, they are not covered. Larger chips that cause pain, and affect speaking and chewing have a great chance of being covered by a dental insurance plan. Repairs for these are typically considered medically necessary

#2. Reason For Chip

The “how” factor is important in determining dental insurance coverage for chipped teeth. The reasons could be:

Trauma or Accident: Most dental insurance plans provide reimbursement if the chip is the result of an accident, as it is seen as unexpected and medically required.
Pre-existing Condition: Depending on the plan and if the condition was previously diagnosed and treated, chips brought on by pre-existing conditions such as teeth grinding or severe decay may be restricted from insurance coverage.
Cosmetic Reasons: Cosmetic surgeries are generally not covered by dental insurance.

#3. Your Insurance Plan:

Your dental insurance plan type plays a crucial role in whether you get dental insurance for your chipped teeth or not. Some plans provide full coverage which covers things like chipped teeth, others don’t.

Does Dental Insurance Cover Orthodontics? Check this out.

Common Treatment Options For Chipped Teeth And Their Potential Dental Coverage Levels

Do you now have a chip in your tooth? What are your options, and will the cost be partially covered by dental insurance?

Let’s examine popular repair techniques and possible dental insurance coverage:

Bonding
Crowns
Veneers

1. Bonding:

This repair is somewhat considered minor and relatively inexpensive as it’s your first choice. Most dental insurance plans offer partial or full coverage for this kind of repair.

It’s the least expensive alternative, usually costing between $100 and $300, and it’s frequently insured if the chip causes you pain or difficulty in chewing. It’s a low-cost, dental insurance-friendly option that requires little drilling and can be fixed quickly.

2. Crowns:

Dental insurance coverage for crowns depends largely on severity and location (eg; back teeth). The more the damage, the more likely you are to qualify for dental insurance coverage. The percentage of coverage available also depends on severity and impact.

Sometimes insurance may pay for 50% or more if it’s determined to be medically necessary.

3. Veneers:

Veneers are cosmetic by nature. Therefore, even if they are used to treat a chipped tooth, dental insurance usually does not cover them, and the cost ranges from $2,000 to $4,000 per tooth.

Factors That Determine The Limit/Amount Of Coverage You Get For Chipped Teeth

Knowing the limits of your coverage is a key factor that should determine whether or not you get dental insurance for your chipped teeth.

Under your coverage, these factors determine your limit:

Deductibles
Coverage Percentages
Exclusions
In-Network vs Out-of-Network Providers
Pre-existing Conditions

#1. Deductible:

This is the amount you pay out-of-pocket before your insurance plan starts to function. Look at your plan to know how much is required for procedures like crowns or fillings. They might be expensive.

#2. Coverage Percentages:

Your plan may have specific percentages that it covers for different restorative procedures. Make efforts to fully understand the coverage percentage for procedures that affect you directly, like bonding, fillings, or crowns.

#3. Exclusions:

Some dental insurance plans have special exclusions for cosmetic procedures or pre-existing conditions. Read through your plan’s exclusion list to ensure chipped teeth repairs (especially for minor chips) do not fall under the cosmetic category or are excluded due to pre-existing dental issues.

#4. Network vs. Out-of-Network:

Understand that using in-network dentists often gives you access to negotiated rates which potentially reduces your out-of-pocket costs compared to going out-of-network.

#5. Pre-existing Conditions:

Some dental insurance plans have no coverage for pre-existing chipped teeth.

Existing Chips: Some dental insurance plans may not include coverage for already existing chips. This can be disheartening, but it is best to be armed with this information before you enroll in any plan.
Underlying Conditions: If your chipped teeth can be traced to a pre-existing condition like cracked tooth syndrome or a weakened enamel, then coverage for this can be limited.
Past Treatments: Your chipped teeth can be considered a pre-existing condition if you have formerly undergone treatment. If this is the case, you could be excluded from coverage.

Types Of Chipped Teeth Repairs and Their Dental Insurance Coverage Level

You already know that the kind of repair determines if your dental insurance plan can cover your chipped teeth. Let’s quickly look at the types of chipped teeth repairs available and the insurance coverage for each of them.

1. Minor Chippings:

These types of chippings generally don’t affect you much. Although they just affect one’s beauty, it is still important to work on them. Procedures that cater to them include; dental bonding and enamel microabrasion.

Dental Bonding: This is a procedure that consists of the use of tooth-colored resins to fix minor chips. This is especially true for areas that affect the beauty, eg; front teeth. As we said earlier, this procedure is usually partially covered by dental insurance, although it is widely known as a cosmetic one.

Enamel Microabrasion: This is for small surface chips. It is a procedure that requires the removal of a thin layer of enamel to smooth the chip. It is generally considered a cosmetic procedure and is therefore not covered by insurance.

2. Moderate Chippings:

These are chippings that could easily find a middle ground. They are usually not too serious, but important enough to require adequate dental attention. They affect chewing, and speaking and sometimes even cause pain.

Examples of procedures that cater to these are;

Composite Fillings: This is a lot like bonding but it covers more areas of the teeth, including decay. Coverage for this depends on your location and material.

Porcelain Inlays/Onlays: These are pieces of chippings that are specially made to replace major portions of one’s chipped tooth. The coverage for this is judged based on the severity and location of the affected tooth/teeth. It could be really high if it involves one’s back teeth.

3. Severe Chippings:

These are chippings that are really bad and require extensive treatments to heal. Here are some of the ways they are treated and how their dental insurance works;

Dental Crowns: These are crucial treatments that leave one with a crown on their teeth. They are important when large chips are involved. Dental insurance coverage for this is usually on the high side. This gets even better depending on the severity and impact.

Root Canal Therapy: A root canal becomes necessary if your chip exposes a pulp(nerve). It is done to remove the infected tissue. This is always covered by one’s dental insurance plan as long it is medically necessary.

Factors Affecting The Average Cost Of Chipped Teeth Repairs (With Dental Insurance)

Several factors come into play when you analyze the average cost of a chipped teeth repair with dental insurance. You look at;

The Severity of the chip.
Repair Type
Location
Dental Insurance Coverage

#1. The severity of The Chip:

A simple chip will cost less than the more complicated procedures that cause deep pain.

#2. Repair Type:

Repair methods differ, so they come with varying price tags:

Dental bonding: Cost varies between $100-$400 (50-80%). It is sometimes partially covered by insurance.
Composite fillings (40-70%): The cost ranges from $150-$600. It is likely covered by dental insurance with some percentage based on material and plan.
Porcelain Inlays/Onlays (40-70%): These usually cost $500-$1,500, but coverage depends on severity and location.
Dental Crowns: Their prices fall between $500-$3,000. There is higher coverage for severe cases impacting function.
Root Canal Therapy: Prices fall within $700-$2,000(30%- 50%). They are usually covered by medical insurance if deemed medically necessary.
Veneers: Cost varies between $500-$2,000(50-80%). They are rarely covered by insurance for chipped teeth as they’re primarily for aesthetic reasons.

#4. Location:

Costs can be calculated depending on your geographic location and the dentist’s fees around that particular region.

#5. Dental Insurance Coverage:

This impacts your out-of-pocket cost. Check your dental insurance plan details for clauses like; annual maximums, deductibles, and specific procedures covered.

Understand that all these factors do not apply equally. Neither do they represent a final option for you. Ensure you communicate with your dentist and insurance providers to get the best-suited plan.

What To Do If Your Dental Insurance Does Not Cover Chipped Teeth

Sometimes dental insurance plans might fall short. For you not to be frustrated, it is best to prepare ahead of time.

Here are some out-of-pocket options that you could consider when dental insurance isn’t available:

Budgeting and saving
Payment plans
Temporary repair kits
Pain management over repair
Community resources
Dental financing options
Budgeting and Saving:

Having a reasonable budget in mind and intentionally saving towards it is a sure way to get your chipped teeth treated despite the lack of dental insurance. This might take some time, but it will give you some control over the finances required for your chipped teeth treatment.

Payment Plans:

Some dentists offer flexible payment plans. People are allowed to pay in installments until they complete their payment.

Temporary Repair Kits:

If your chip is not severe, consider using a temporary repair kit. They help smooth out the rough edges and reduce the possibility of irritations. You can find them at drugstores. You can use this temporary solution until you can afford professional care.

Pain Management Over Repairs:

If the chip doesn’t cause you much pain or discomfort, consider taking some over-the-counter medications. Also, practice good hygiene. This will help until you can afford professional care.

Community Resources:

Some communities have dental clinics or charity organizations that offer dental treatment for free or at a discounted rate. Explore the possibility of this in the area where you are.

Dental Financing Options:

There are available dental-financing companies that specifically offer loans for dental procedures. They have different repayment and interest rates. Please do your best to understand the terms and conditions before going into it.

Does Dental Insurance Cover Chipped Teeth? - — Does Dental Insurance Cover Chipped Teeth? –

Some Types Of Dental Financing Options You Can Maximize As Alternatives To Dental Insurance Coverage

Consider these:

Third-Party Lending
In-House Plans
Credit Cards With Special Offers

Let’s discuss them

#1. Third-Party Lending:

Some companies offer dental care loans with varying interest rates and repayment terms. Some examples of these companies are; CareCredit and LendingClub.

Consider this as an option that can help solve your chipped teeth dilemma quickly.

#2. In-House Plans:

Many dentists offer their own flexible payment plans that allow their patients to get good treatment and pay in installments.

You can try this option and discuss it with your dentist. There may just be an awesome plan for you!

#3. Credit Cards with Special Offers:

You probably never knew that some credit cards offer introductory financing periods and cash-back rewards for health care spending. This also applies to dental procedures. So what are you waiting for?

Don’t just pick any option because you are desperate. Settle down and compare terms from different dental care financing houses. Be realistic about your repayment abilities and use a plan that won’t give you a heart attack.

Also, consider hidden fees that could arise from things like; late payments and other charges that could increase the total cost of your plan.

Frequently Asked Questions

[sc_fs_multi_faq headline-0=”h3″ question-0=”Does dental insurance cover chipped teeth?” answer-0=”Yes, but it depends on the severity of the impact, the repair type, and the type of insurance plan you are on.” image-0=”” headline-1=”h3″ question-1=”How can I prevent chipping my teeth in the future?” answer-1=”Practice good oral hygiene and avoid biting on hard objects, or using your teeth as a tool. Additionally, consider using a mouth guard when you participate in sports that put your teeth at risk.” image-1=”” headline-2=”h3″ question-2=”How much does it cost to repair a chipped tooth?” answer-2=”The cost of a chipped tooth repair depends on the type of repair required.” image-2=”” headline-3=”h3″ question-3=”Are there any risks associated with repairing a chipped tooth?” answer-3=”The risks associated with repairing a chipped tooth are usually low. There could sometimes be risks of infection, bleeding, or other complications. But this only happens on occasion.” image-3=”” headline-4=”h3″ question-4=”Is it better to repair a chipped tooth immediately or wait until it is more severe?” answer-4=”The best option is to get it repaired as soon as possible. If you wait, you could make matters more complicated. This is because a chipped tooth is susceptible to more damage and can lead to decay and infection.” image-4=”” count=”5″ html=”true” css_class=””]

Important Recommendation

Conclusion

Your oral health is always a priority and that includes the smallest chipped teeth. We hope you’ve learned ways to handle it through this article Whatever you do, don’t be discouraged if you are unable to get a dental insurance plan for your chipped teeth. Let us know which step you would be taking.

Can’t wait!

Cheers!