Dental Insurance & Cosmetic Dentistry: Are There Exceptions for Coverage?  

September 4, 2024

Filed under: Uncategorized — swestdental @ 6:55 pm
man preparing for cosmetic dentistry

Having a healthy, beautiful smile that appears flawless is what many people desire. Unfortunately, daily wear and tear, stains, and small imperfections leave individuals unhappy with how their teeth look. The good news is that cosmetic dentistry can fix all of these issues; however, it’s no secret that these services (i.e., veneers, teeth whitening, etc.) are usually not covered by dental insurance. What should a person do? For some, paying out of pocket isn’t possible. Are there instances where partial coverage is provided? Read on to discover how much financial help you can expect from your insurance company.

Why Don’t Dental Insurance Companies Cover Cosmetic Dentistry?

The most frequently used answer as to why dental insurance companies do not commonly provide coverage for cosmetic dentistry is that these services are not deemed “medically necessary.” This means that they do not help to restore damaged or decayed teeth. Instead, they are used to enhance the visual appeal of a person’s smile.

This can be frustrating for many patients who may think otherwise, especially since many researchers now find that cosmetic dentistry does more than improve the aesthetics of teeth and gums. It also positively affects an individual’s overall health and well-being, especially their mental and emotional state.

Are There Exceptions for Insurance Companies to Cover Cosmetic Dentistry?

Yes, there are times when a dental insurance company will extend partial coverage for a particular cosmetic service.

For example, if a person is in an accident or suffers some sort of facial trauma, they may need to have a few of their teeth replaced. While metal crowns are offered by many dentists, the truth is that metal-free restorations are also available, allowing for a more beautiful appearance.

Since these teeth need to be repaired to avoid more serious oral health problems later on (i.e., infection or further damage that requires root canal treatment or tooth extraction), dental insurance may cover a portion of the cost for one or more metal-free dental crowns.

Another example is if an individual suffers from a serious infection that warrants gum recontouring. This cosmetic solution can remove unhealthy tissue and produce a more aesthetically pleasing appearance.

Are There Other Ways to Pay for Cosmetic Dentistry?

If the service a patient desires is not approved by their dental insurance company, there is another way to cover the cost of treatment – flexible financing. Many dental offices partner with third-party companies like CareCredit to make it easier for individuals to pay off their care over time.

Instead of being forced to come up with the total amount at the start of treatment, it can be divided into manageable monthly installments so that a person can pay it back on a timeline that works for them.

Cosmetic dentistry does not have to be out of reach, and it can partially be covered by dental insurance if the situation is to some degree medically necessary.

About the Author
Dr. Hamid Ranjbaran or “Dr. R” as he is known by his patients enjoys helping individuals in need. When treating individuals with cosmetic procedures, he and his team can create an appearance that is truly one of a kind. However, when payment for such services is required, he will also do everything possible to help individuals pay as little as possible. Working with the insurance company on a patient’s behalf, we will do our best to lower out-of-pocket costs. In situations where the service cannot be partially covered by insurance, though, we will recommend flexible financing through CareCredit. Contact us at (505) 896-9399 to find out what we can do to help you get the smile of your dreams at a price you can afford.

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