Does dental insurance cover cosmetic dental work?

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Dental insurance does not usually provide benefits for cosmetic treatment.

That being said, there can be many necessary services that can improve the patient's appearance. For example, defective fillings in the front teeth may require replacement, and this can provide cosmetic benefit to the patient by eliminating discolored restorations with underlying decay. Also, a tooth or teeth may be discolored, and even weakened, due to large restorations, and a crown (cap) may be indicated to restore and strengthen the tooth. This, of course, can improve the appearance of a tooth or teeth. Even when only one tooth is crowned, if consideration is given to shape, shade and relationship to gum and adjacent teeth, cosmetic improvements can be achieved.

Dental Insurance will cover some cosmetic dental procedures but not others. Fixing a chip in a front tooth could be considered "cosmetic" and would be covered by dental insurance to a certain extent. Almost no procedure, with the exception of preventative care, is covered at 100% by dental insurance.

In my practice, I have seen insurance cover part of cosmetic porcelain veneers and bonding, which will help reshape, align and change the color of front teeth. A lot of this depends on the specific insurance plan and the reasons for doing the treatment. It's always a good idea to submit a pre-determination to an insurance plan to see if desired treatments are covered.

Dental insurance will never cover bleaching or tooth whitening. Talk with your dentists about what sort of cosmetic procedures you would like done, and they can give you a better idea of your coverage.

Usually no. You should think of dental insurance as a gift card. It will help with a little bit of dental work but not too much.
Gregory J. Jorgensen, DMD
Orthodontics & Dentofacial Orthopedics
Dental insurance is a lot like car insurance, you can pick and choose the coverages your policy will include. In the same way that you can choose "towing" or "glass replacement" as options for your auto insurance, dental insurance companies offer coverage options too (for a price of course!). If your company has purchased your policy for you, it may or may not have chosen to include certain cosmetic procedures. Your best bet is to contact your employer's benefits department and ask about your particular policy or have your dentist's office staff check your benefits for you. Good luck!
Dr. Michael Roizen, MD
Internal Medicine
Cosmetic dentistry is the term used to refer to procedures that can make the teeth look better, but may not be medically necessary, so often, these procedures are not covered in dental benefits plans. But before you get so down that the concept of smiling becomes irrelevant, make a quick call to your dental benefits provider. You should be able to get some answers there. And while you’re at it, call your dentist. He or she may be able to offer some lower-cost options that fit into your budget -- and that is truly something to smile about, even if your teeth aren’t perfect!

Continue Learning about Dental Insurance Plans

Dental Insurance Plans

Dental Insurance Plans

You are at the dentist and have been asked to "open wide", only it's your wallet and not your mouth that is being asked to open. If this is a concern, various dental plans may come to the rescue. Like regular insurance, there are ...

Health Maintenance Organization plans (HMO) and Preferred Provider (PPO) plans. Most work on a fee for service basis where a particular treatment is reimbursed at a standard rate. Plans often have annual limits on services, and may pay for cleaning only once or twice a year. Few plans cover cosmetic services like whitening. Many times major services need to be pre-approved. With most plans you can be assured of a standard level of payment for required basic services inside of a coverage network.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.