Whether you wish your teeth were brighter, straighter, or just generally more attractive, cosmetic dentistry can help you achieve the smile you always dreamed of. However, while most dental insurance plans will cover dental cleanings and procedures that are necessary for the health and functionality of your teeth, many policies don’t cover dental services that aren’t medically necessary.
Of course, there are gray areas – for example, custom dental crowns can be used to enhance the appearance of your teeth while also being necessary to repair damage caused by decay or an injury. So how can you best determine if your insurance will cover any of the costs of cosmetic dental procedures or if you can expect to pay completely out of pocket?
In this guide, we’ll help you identify what counts as an “elective” cosmetic dental procedure, how to determine your benefits and coverage, and options to make cosmetic dentistry more affordable.
Want to make your smile goals a reality but concerned about the cost? Schedule a free consultation with Alaska Dental Arts and we’ll walk you through your options!
What Counts as a Cosmetic Dental Procedure?
Dental services are often categorized as preventative, cosmetic, or restorative. Preventative dental treatments include essential visits with your dentist to clean your teeth, examine your mouth, and fortify your oral health. Preventative dentistry is generally covered by your dental insurance plan and can include bi-annual dental checkups, X-rays, and some procedures such as dental sealants for children.
Restorative dental procedures are medically necessary treatments that address an issue with your teeth or gums. For example, if you have gum disease, a decayed tooth, or accidentally chip your tooth, you will need restorative dental treatment to improve the health and function of your teeth.
Cosmetic dental procedures improve the appearance of your teeth and/or gums and can include:
- Teeth whitening
- Dental implants
- Teeth shaping
- Tooth gaps
- Dental bonding
- Gum contouring
- Traditional braces
- Clear aligners
- Porcelain crowns
However, it’s important to remember that there is some overlap between cosmetic and restorative dental treatments. If you are interested in a procedure such as professional teeth whitening or Invisalign from a cosmetic dentist because you want a more beautiful smile, then it will likely be considered a cosmetic procedure by your insurance. However, there is a chance of full or partial coverage if you are getting veneers or implants because your teeth were injured – with the added benefit of a more beautiful smile!
Checking Your Dental Coverage for Cosmetic Procedures
Whether or not cosmetic dental procedures are covered by insurance is ultimately a question for your insurance provider. Your dentist’s administrative team will often contact your insurance and determine eligibility before you have any work done. However, you should always check your benefits to get a clear idea of what you can expect.
Many cosmetic procedures are covered on a case-by-case basis. Your dental plan may include partial coverage for some cosmetic work, and you might find that parts of your treatment are covered while others are not. For example, your dentist might need to guide a guide or other prosthetic that insurance does not cover. And it is ultimately up to your insurance to decide if a procedure is deemed elective or medically necessary – although you can attempt to petition your case or speak with a representative.
To determine what you can expect to pay for a cosmetic dental procedure, you’ll want to consider the following:
- If You Have Dental Insurance: You’ll first want to ensure that your plan includes coverage for dental care. If you have a health insurance plan, this doesn’t necessarily mean you have dental insurance. Some medical insurance plans include both health and dental coverage – however, it’s very common for health insurance to exclude dental. In this case, you would need to purchase a separate dental insurance policy to receive coverage for any dental care.
- Your Insurance Plan Type: Once you’ve confirmed that you have dental benefits, you will need to identify what type of plan you have. While there is a wide range of plan types, some of the most common include Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans. With a PPO plan, you have more freedom in choosing a provider. However, with an HMO plan, you need to select an in-network provider.
- What Procedures Are Covered: Every dental insurance plan is unique in the coverage it offers. Your plan might include 50% coverage for all dental procedures. Or, your plan might offer no coverage for elective services and minimal coverage for restorative work. You might even find that some specific treatments, such as dental implants, are 100% covered. You can look through your benefits information or call your provider to learn the specifics.
- Your Deductible and Co-Pay: Even if you can confirm that your cosmetic dental procedure is covered, you need to understand your plan’s deductible and co-pay. Your deductible is the amount your plan requires you to pay before they cover any costs. For example, if you have a $1500 deductible and the cost of your veneers is $3000, you can expect to pay at least $1500 before insurance kicks in. Your co-pay is the percentage of your bill that you will be responsible for.
How to Make Cosmetic Dentistry More Affordable
If you have little to no insurance coverage for cosmetic dental procedures, are there any options for lowering the cost of your care? Fortunately, your dentist may offer several options that can disperse the cost of your procedure or significantly bring down costs:
- Take advantage of financing or payment plans: If you can’t pay for the full cost upfront, ask your dentist if they have any in-house financing options, offer no-interest payment plans, or accept outside financing options such as CareCredit.
- Consider upgrading your dental insurance plan: A simple dental insurance plan might be enough if you have a relatively healthy mouth and minimal dental needs. However, if you have severe dental issues or are considering investing in more expensive cosmetic procedures, it could be worth shopping for a premium plan that offers better coverage.
- Ask your dentist about discounts: Your dentist might offer discounts to patients with no insurance coverage. While not every dental office has this option, it’s worth asking if you qualify for any savings.
- Budget for cosmetic dental services: The good thing about cosmetic dental services is that they don’t need to be done right away! If you know you want to whiten your teeth or get sparkly new veneers, consider setting a goal date and budgeting for the procedure.
- Don’t skip routine dental appointments: Many dental insurance plans cover routine dental care in full! This means there’s no reason to skip your bi-annual cleanings and exams. By keeping up with your dental hygiene, you keep your teeth whiter and more beautiful for longer – making it easier to keep up with your dental health goals without paying for more costly procedures.
Discover Affordable Cosmetic Dentistry at Alaska Dental Arts
Alaska Dental Arts is Alaska’s go-to cosmetic dentistry provider, with two convenient locations in East Anchorage and the North Pole. We provide a full range of dental services, including expert cosmetic dentistry, restorative work, and preventative care.
We also are dedicated to doing whatever we can to make your care as affordable as possible. We accept most insurance plans, CareCredit, and offer flexible financing options. We also invite you to learn more about our Dental Savings Plan, which provides highly competitive discounts on all services – including $1000 off Invisalign and 50% off teeth whitening!
If you’re ready to improve your smile, we’re happy to hear your goals and talk through your options. Ready to make that smile shine? Schedule a consultation at Alaska Dental Arts today!