Posted by According to Grand View Research, the global cosmetic dentistry market size was valued at $33.3 billion in 2022 and is expected to grow at a rate of 13.5% from 2023 to 2030. You might be looking to join these statistics, but you’re asking first “Does dental insurance cover cosmetic dentistry?” You are at the right place.
No, dental insurance does not cover cosmetic dentistry, but there are ways you can get dental insurance with cosmetic dentistry, and that’s what this article is about. You will also learn alternative ways to get your cosmetic dentistry without insurance.
Let’s read together
Table of Contents
Does Dental Insurance Cover Cosmetic Dentistry?
No, it doesn’t. Cosmetic procedures are generally considered unnecessary, but in certain cases, dental insurance does have coverage for them. This applies when they can actually improve your oral health and function.
Dental procedures are usually split into two categories, the restorative procedure which entails all medically necessary treatment, and the elective procedure, which involves procedures that are aimed at improving one’s teeth’ appearance without any medical implication.
Cosmetic dentistry is another name for elective procedures. This means that we are concerned with procedures that only satisfy the ethical pleasure of a patient.
Sometimes, the line between a restorative and elective procedure can get blurred and a patient can easily take advantage of this. Other times, restorative and elective procedures are the same, in that, they could involve the same treatment pattern.
What is Cosmetic Dentistry?
Dental procedures are usually split into two categories, the restorative procedure which entails all medically necessary treatment, and the elective procedure, which involves procedures that are aimed at improving one’s teeth appearance without any medical implication.
Cosmetic dentistry is another name for elective procedures. This means that we are concerned with procedures that only satisfy the ethical pleasure of a patient.
See this to know if dental insurance covers second opinions.
How Dental Insurance Can Cover Cosmetic Dentistry
The sure way dental insurance can cover cosmetic surgery is through a skillful combination of restorative and cosmetic procedures.
Imagine having an accident that affects your teeth. You might need a necessary procedure like a dental crown to replace a chipped tooth. Treating this will ensure you end up with a new shiny porcelain crown, and you will get insurance coverage for it. That’s how it works!
This blending of procedures can also happen if;
- You need gum contouring as part of a periodontal surgery due to infection or injury.
- You get an orthodontia placement to correct shifted teeth that resulted from an accident or injury.
- You get veneers to help repair worn-down enamel. While treating the structure of your tooth, you get a nice cover for your damaged teeth.
- You get dental implants to help your bones and reduce the risk of further tooth loss.
- You get Invisalign to correct medical issues like overbites and underbites.
If you’re scheduled for a restorative procedure already, you can personally request that your dentist make the result physically appealing. This would ensure you get the perfect dentition without having to worry about insurance coverage.
Dental Insurance Doesn’t Cover Purely Elective Procedures
Not all surgeries can pass as part of a restorative procedure. If you do not have a clear medical reason to undergo the procedure, your dental insurance plan will have you pay out-of-pocket.
Purely elective procedures only serve to elevate your teeth outward look and that is not a concern to your dental insurance providers.
Here are some of the procedures that are purely elective and cannot be covered by dental insurance:
- Teeth Whitening: This is only intended to give your teeth a clean, bright look. It does not add to the general health of your teeth, neither does it subtract.
- Veneers: Veneers are thin porcelain covers used on the surface of the tooth. Although you can sometimes have veneers as a restorative procedure, they are elective. When a veneer is requested without a medical reason, it won’t be covered by dental insurance.
- Shaping: This is also usually intended to give your teeth an attractive shape. The lack of it does not put you at any medical risk. So you are unlikely to obtain dental insurance coverage for it.
- Invisible Dental Aligners: When Invisalign is strictly meant to improve your teeth’ appearance, you won’t get dental insurance coverage for it.
- Dental Implants: You can generally survive with one missing tooth. If you decide to get an implant without a medical reason such as; a diseased gum, you won’t get dental insurance coverage for it.
- Gum Contouring: The removal of extra soft tissues can sometimes be medically necessary. A situation where it is purely intended to improve your teeth’s appearance cannot be covered by dental insurance.
Would you love to know if dental insurance covers retainers? See this amazing guide.
Cost Of Some Cosmetic Procedures That Are Common Covered By Dental Insurance
You already know that dental coverage only exists for cosmetic procedures that are integrated into restorative procedures.
Here is the average cost of some of the procedures and the percentage you can expect to be covered by dental insurance:
- Porcelain Veneers: They cost between $500-$2500 per tooth. As a restorative procedure, dental insurance coverage ranges from 50-80%.
- Dental Crowns: They cost between $800-$3,000 per tooth. As a restorative procedure, insurance coverage ranges from 50-80%.
- Gum Contouring: They cost between $1,000-$2,000. As a restorative procedure, dental insurance coverage ranges from 50-80%.
- Orthodontic placements: They could cost anything between $2,500-$8,000. Sometimes, they even cost more. As a restorative procedure, coverage ranges from 50-80%.
- Dental Implants: They cost between $3,500-$5,000. Dental insurance coverage ranges from 50-80%.
- Invisalign: They cost between $4,000-$8,000. insurance coverage ranges from 25-50%.
Meet with your dental insurance provider to know the exact percentage of coverage your specific dental insurance plan will provide for your procedure. This will enable know what is left as the out-of-pocket cost and enable you to plan toward covering it.
10 Ways To Pay For Cosmetic Dentistry Without Dental Insurance Coverage
Dental insurance is your only option. There are several other ways to get that procedure without it. Here are ten sure options you can consider:
#1. HSA (Health Savings Account):
An HSA allows you to save up money for medical expenses without having to worry about taxes. This means you can pay for your cosmetic dentistry procedure without thinking about the added tax.
HSA does not apply to everyone, so you should check in with your tax advisor to ensure you are eligible.
#2. FSA (Flexible Spending Account):
FSAs are usually provided by employers as part of one’s benefit package. It can be used to pay for certain health care expenses including cosmetic dentistry.
Although this doesn’t apply all the time, your specific FSA plan may not allow you the option of paying for a cosmetic dental procedure. You should check with your employer or administrator to get the right information.
#3. Medical Credit Card:
A medical credit card is specially designed with lower interest rates, to cover one’s medical expenses. It is definitely a good option if you want to spread out the cost of your cosmetic procedure over time.
You should only consider using a medical credit card if you are confident that you can handle the interest and pay off the balance within the slated time frame.
#4. Home Equity Loan:
If you want that procedure bad enough, you could consider getting a home equity loan. In this case, your home is used as collateral and you can use the loan to pay for your cosmetic procedure.
You should keep in mind that if you are not able to pay back the loan on time, you are at risk of losing your own home. So, consider this option only if you are confident.
#5. Dental Discount Plan:
This plan offers discounts on dental procedures to patients who are part of its membership-based plan. It is not an insurance replacement, but it is a good option if you need to save money on dental care.
This works as long as your dentist is a participant in the program. You also have to make sure that your dentist can offer the type of dental care you need; cosmetic procedures.
#6. In-House Financing From Your Dentist:
Some dentists allow their breakdown payments into monthly installments. You can discuss this with your dentist and find out if this option is available for you to cover your cosmetic procedure.
#7. Dental Tourism:
You don’t have to get your cosmetic procedure from a dentist within your locality. Consider traveling to a place where dental care costs are lower.
Before taking this option, do thorough research and find a reputable dentist in the country you’re planning to visit. Also, consider travel costs.
#8. HRA (Health Reimbursement Arrangement):
This is also given as part of an employee benefit package. You can use an HRA to pay for your health care expenses including cosmetic procedures!
An HRA plan is not given to every employee, so you should find out the eligibility requirements to know if you qualify.
#9. Dental Savings Plan:
This is a lot like the dental discount plan but without the discount. You also get to be part of a membership program and save up for your dental procedures, but you pay the full cost of all your procedures.
#10. Borrow From Family and Friends:
If all else fails, you still have family right? If you have a good relationship with your family, consider asking one or two members to lend you the money for your cosmetic procedures. Don’t forget to ask your friends too!
Frequently Asked Questions
Does dental insurance cover cosmetic dentistry?
No, dental insurance does not cover cosmetic dentistry. Coverage is only applied if the procedure is both elective and restorative. In such cases, dental insurance covers a particular percentage of the procedure cost.
Are there any tax benefits for cosmetic dental procedures?
Yes, there are! Cosmetic dental procedures may be eligible if the procedure is medically necessary, it can qualify for a medical expense deduction
Can I get a second opinion from another dentist?
Yes, many dental insurance plans allow you to seek second opinions from another dentist before embarking on your procedure. This is vital in helping you obtain the best treatment possible.
Do I need a referral from my regular dentist to see a cosmetic dentist?
No, you don't need a referral from your regular dentist to see a cosmetic dentist. But you should consider speaking to your regular dentist about your plans. They may be able to give you good recommendations.
Is there a waiting period for cosmetic dental procedures under dental insurance?
Yes, some dental insurance plans have specific waiting periods for certain procedures. You may have a waiting period of six months for procedures like electives or bonding.
Important Recommendation
- Does Dental Insurance Cover Electric Toothbrushes?
- Does Dental Insurance Cover Orthodontics?
- Does Dental Insurance Cover Gum Grafts?
- Does Dental Insurance Cover Oral Cancer Screening?
Conclusion
We hope you’ve gotten a better understanding of how cosmetic dentistry is covered by dental insurance through this article.
Don’t forget to compare the plans from each company that you click. You can also consider the alternatives. We are rooting for you to get that confident smile!
Cheers!
I am sure this paragraph has touched all the internet users.
Its a really good work!
Thank you so much, Garcia.