Does Dental Insurance Cover Crown Replacements? #1

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According to the American Dental Association, over 25 million Americans get crown replacements each year. And for many of them, the cost of a crown replacement is a concern. This begs the question “Does dental insurance cover crown replacement?”

The truth is, that dental insurance will cover crown replacement if it is deemed medically necessary.

In this article, we have done a lot of research to give you the right information about crown replacement; the why, cost with and without insurance, how to get crown replacement without insurance, and lots more.

Let’s get started.

Does Dental Insurance Cover Crown Replacements?

Yes, dental insurance does cover crown replacement, but only when it is medically recommended. It is important to note that cosmetic crown replacements are not covered by dental insurance.

Crown replacements can be necessary for several reasons; damage through accidents, a cavity that has become too large, etc. Whatever the reason, it is important to know how dental insurance may or may not cover crown replacements.

How Can A Crown Replacement Be Medically Necessary

Dental insurance plans typically cover crown replacement if it is medically necessary. Some medically justifiable reasons could be; a tooth that has been weakened by decay, a chipped tooth from an accident, a cavity that has gotten too large for a filling, etc.

The amount of coverage provided for a crown replacement will be determined by the type of dental insurance plan and the cost of the crown. There could be deductibles, limitations exclusions, and other out-of-pocket costs.

You might have heard a dental crown but you don’t know what it is. Before we continue, let’s take you out of the dark.

What is a Dental Crown?

A dental crown is a cap-like material used to cover one’s tooth. It is only used when the original tooth has been damaged either by accident, tooth decay, etc. Dental crowns are made from a variety of materials; porcelain, metal, and ceramics.

The type of crown you can get is often determined by what you can afford.
A crown placement usually requires two procedures. The first visit to the dentist involves getting an impression of the tooth and getting it prepped for placement.

The crown is placed on the second visit.
Dental crowns usually last between five to fifteen years with adequate maintenance. Most dental insurance providers only provide coverage for a crown replacement if it has lasted about five to seven years.

Does Dental Insurance Cover Crown Replacements? - Crown
Dental insurance plans will typically cover crown replacement if it is medically necessary.

See this to know if dental insurance covers porcelain crowns.

When Do I Need To Replace My Crown?

You may not know the appropriate time to get a crown replacement without the help of your dentist. We are here for you! Here are a few signs to note:

  • A cracked or broken crown.
  • A loose or shifting crown.
  • Pain and discomfort.
  • A stained or discolored crown.
  • A crown that doesn’t quite fit anymore

If you notice any of these, go see your dentist.

In the next section, we will discuss the cost of a crown replacement.

Does A Crown Replacement Cost As Much As A New Crown?

A crown replacement is not the same thing as a new crown, therefore the cost differs. If you want to get a crown replaced, it is usually cheaper because the procedure does not require the same amount of time and material that a new crown requires.

While a new crown may cost anything from $500-$2500 per crown, a crown replacement usually costs about $500-$1500. This cost does not apply everywhere. They could vary depending on; the plan and type of crown.

Read Also: Is Oral Surgery Covered By Dental Or Medical Insurance?

What Is The Cost of Crown Replacements With and Without  Insurance?

The cost of dental crown replacements with and without insurance differ largely. Here’s a quick breakdown also based on type of material:

The Cost Of Crown Replacement With Insurance:

  • Porcelain or ceramic crowns: $800-$1,500.
  • Metal crowns: $700-$1200
  • Zirconia crowns: $800-$1,500
  • Porcelain Fused to Metal(PFM): $800-$1,500.

The Cost Of Crown Replacement Without Insurance:

  • Porcelain or ceramic crowns: $1,000-$2,500
  • Metal crowns: $900-$2,000
  • Zirconia crowns: $1,000-$2,500
  • Porcelain Fused to Metal: $1,000-$2,500

You have to keep in mind that these prices have only been classified according to plan type and insurance. Other factors like; specific dentists, and location can also affect prices.

How Can I Get Insurance For My Crown Replacement?

One often has to suffer the dilemma of getting their insurance company’s approval before getting a crown replacement. We don’t want that for you!

Here are 3 proven steps you should take to get immediate approval from your insurance company:

  • Pre-operative and post-operative X-rays
  • Give detailed information about your need for a crown replacement
  • Submit your claim

#1. Pre-operative and Post-operative X-rays:

A pre-operative x-ray is so important for you to get approval for a crown replacement. It helps show the extent of the wear on your old crown and proves the medical necessity of a crown replacement.

Most dental insurance plans will have certain amounts for coverage depending on how worn the current crown is. An x-ray will easily persuade them.

A post-operative x-ray is also important, although not as important as the one before. It allows your company to confirm that you got the treatment they paid for.

#2. Give Detailed Information About Your Need For A Crown Replacement:

Do you really need that crown replaced? then tell them all they need to know to be convinced.

This could mean providing information about the state of the crown (this should be done by your dentist). There is also a possibility that your crown has lasted for so many years and you don’t remember when it was placed.

Try as much as you can to obtain that information, possibly from your dentist’s records. This will boost your chances. Don’t forget to complete Box 43 of the ADA dental claim. Also, enter the date of initial placement in box 44. As you do this, include information about; why the crown needs to be replaced. Also, make efforts to find out what the replacement clause is from your dental insurance provider.

#3. Submit Your Claim:

All your documents and evidence should be put together and submitted as your dental claim. Do your best to find out the appropriate time to submit, so it can be attended to.

What If I Can’t Get Dental Insurance For My Crown Replacement?

So what if you can’t get dental insurance to cover your crown replacement? Here’s what to do:

  • Dental Saving Plans
  • Dental Schools
  • Medical Credit Card
  • Dental Discount Plans
  • Cheaper Crowns
  • Discussing With Your Dentist

1. Consider Dental Saving Plans:

These plans offer dental procedures at a discounted rate. You could save up a lot of money from saving up for your crown replacement without the extra money.

2. Dental Schools:

You probably haven’t thought about it, but a dental school is one of the best places to get your crown replaced at a reduced cost. This will also save you a lot of money.

3. Medical Credit Cards:

These are cards you could use to pay for medical expenses and reimburse later. This may not be your ideal plan because it involves interest and you have to pay up at a stipulated time.

4. Dental Discount Plans:

These plans specialize in giving discounts only for dental procedures. You could be given a discount to get your crown replaced.

5. Consider Getting A Cheaper Crown:

The different types of crowns have different prices. You might want to consider getting a metal crown. Although this is not the best option, it is better than having no crown at all.

6. Talk To Your Dentist:

This might be your best option. You can easily have a chat with your dentist and come to an agreement that permits payment in installments over some time.

How Can I Maintain My Replaced Dental Crown?

Whether or not you’re getting your dental crown replaced, you must maintain healthy practices that will keep them in good shape.

Here are tips on how to maintain your dental crown:

  • Brush and floss regularly. Just like you would do with your natural teeth.
  • Avoid chewing on hard objects like ice and candy. Don’t put extra stress on your teeth by grinding them or clenching your teeth.
  • Use fluoride toothpaste and mouthwash to wash your mouth. It helps strengthen your enamel and protects your crown from damage.
  • Avoid acidic food and drinks; soda, citrus fruits and drinks, coffee and tea, etc.

Some Recommendable Insurance Providers That Cover Crowns

We have experienced the following insurers, and you can try them for your crown replacement:

Frequently Asked Questions

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Important Recommendation


I am happy you made it to the end of this work.

We hope this article has helped you gain adequate knowledge to get your dental crown replacement without fear or worry. Remember, even if a crown replacement is not covered by insurance, there are other options available for you. Just pick one on the list!

See you again!



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