Does dental insurance cover crowns?

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Are crowns covered by dental insurance? The short answer is yes, but not in all cases. The most important determinant is the reason for the procedure. If done for health reasons, coverage is possible. If this is only done for cosmetic reasons, there is a good chance that the crown will not be covered.

Key points to remember

  • Dental insurance covers crowns, but only when medically necessary.
  • Coverage for a crown is typically 50% of the cost of the procedure, with the patient responsible for the remainder.
  • Waiting periods of up to one or two years after purchasing dental insurance may apply to its crown coverage.

What does dental insurance generally cover?

The typical annual maximum dental insurance coverage cap is a median of $1,500. It covers procedures strictly related to health and wellness, and it has a three-tier structure known as 100-80-50.Inasmuch asInasmuch as

Preventive care, such as annual cleanings, X-rays and sealants, are covered at 100%. Basic procedures, such as fillings, extractions and periodontal treatment for gum disease, are covered at 80%. Major procedures (crowns, bridges, inlays and dentures) are covered at 50%. Depending on your plan, root canals can fall into the basic or major category. Most plans focus on preventative and basic care, and not all procedures are covered.Inasmuch asInasmuch as

Most insurance companies have a waiting period for new patients, although some do not. This waiting period generally applies to non-emergency procedures, such as crowns, and typically ranges from a few months to 12 months, although it can be up to two years for some companies.Inasmuch asInasmuch as

Annual coverage limits, which can be as low as $1,000 despite the median mentioned above, can lead to a situation where a filling or cavity lost earlier in the year has already eaten up much of the allowance. dental this year. This would likely result in a crown that is less than 50% covered, so you need to be strategic about when you schedule certain procedures.

$807 to $2,015

The price range for a single crown depending on the material used

How much does a dental crown with insurance cost?

Most dental plans cover the cost of dental crowns in cases where a patient has a weak or cracked tooth. However, crowns are generally not covered if they are requested for cosmetic reasons only. This is because dental insurance generally does not cover cosmetic procedures, which exist for the primary purpose of improving the appearance of a patient’s teeth and smile rather than for health reasons. Other cosmetic procedures include whitening treatments, veneers, bonding, and smoothing procedures, such as Invisalign. The patient must pay the full cost of these treatments.

Although the cost of crowns varies depending on whether the material used is porcelain or metal, the price can range from $807 to $2,015 per crown.Inasmuch asAnd remember that the cost is usually only 50% covered. The patient must pay the rest. Dentists can provide preliminary estimates and many offer payment plans. Additionally, credit plans such as CareCredit offer low-interest financing methods, and some dental schools offer low-cost dental procedures. Employer-sponsored plans generally require lower insurance premiums due to group coverage.

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