Does insurance cover removable dental space maintainers?

This procedure is typically called “transitional partial denture/flipper".

We have found that if your insurance is billed for this procedure, they normally will not cover the permanent restoration that comes later on. Let's say you have an accident and a tooth towards the front of your mouth is lost. Your dentist may make you a flipper while deciding the next step: bridge or implant. The flipper will maintain the space and fill in the empty site temporarily. If insurance is billed for the flipper, they may not pay for the bridge or implant -- whatever is the final treatment.

Be educated about your insurance plan. You need to know whether you can go to a dentist in our out of your network. You need to know the maximum amount to be paid out in one calendar year (usually $1,200 to $1,500 per year).

You also need to know the % they will pay on a given procedure type -- Exams, cleaning, radiographs are considered preventive and usually covered to 100% of the UCR (usual customary reasonable). The “Major" category may include crowns -- if your dentist charges $1200 for a crown, and the insurance pays 50% of this, you will normally be responsible for 1/2 of that amount. Your insurance company will also outline what is NOT covered… every plan is different.

Dental insurance was intended as a help for care. It was never intended to cover all Dental needs. Ask your dentist for a predetermination to be sent in prior to treatment so you can have a better idea what may be covered.

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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.