Cosmetic Dentistry Procedures
that Dental Insurance Doesn't Cover
Dental insurance generally won't cover these cosmetic dentistry
procedures:
 | Porcelain veneers, when placed for the first time,
because they are usually done for the sake of appearance only. See below for exceptions
to this. |
| Bleaching or
tooth whitening procedures will be denied by your dental plan. There is no way to
get around this. Tooth whitening is always a cosmetic procedure. |
| Bonding to correct a space between your teeth (a diastema), when it's done
for the first time, is almost always not covered.
Tooth bonding for other purposes
may receive some coverage. |
Situations in which dental insurance will often provide benefits for cosmetic
dentistry:
| Replacement porcelain veneers,
if the original veneers have deteriorated. There is a clause in most
dental insurance contracts that requires the company to reimburse for the replacement
of defective dental work, and there is usually not a restriction for the type of dental work
that is being replaced. If the deterioration of the porcelain veneers is documented, then
replacement veneers will often be approved.
However, a word of caution is important here. Usually, the insurance company has a low-level
clerk whose job it is to initially screen the claims. This clerk is told to reject any
claims for porcelain veneers because they are cosmetic. A successful technique for
working around this bureaucratic obstacle is to submit first a pre-treatment estimate to
the company documenting the deterioration of the porcelain veneers and proposing to replace
these with porcelain crowns. This will then come back approved. Then, the office can write back to
the dental insurance company with a revised pre-treatment estimate saying that you have
decided to replace the worn-out veneers with new porcelain veneers. Usually, that proposal
will come back approved. Don't expect the porcelain veneers to be covered completely, but
you will get some benefits for the procedure. |
| Braces for straightening your teeth (orthodontics), are covered
by many dental plans. Usually it is an optional coverage that you can elect when you sign
up.
If your dental plan includes orthodontic coverage, you may be able to get porcelain veneers
covered in lieu of braces. Again, to avoid the automatic rejection you will face from
the clerk when the word "porcelain veneers" shows up on your pre-treatment estimate or your
claim, first submit all the documentation required for the approval of orthodontic coverage.
If that is approved, then send in a second estimate saying that you've decided to do
porcelain veneers in lieu of braces. Many times the dental insurance company will provide
some benefits for the
veneers in those circumstances. |
| A chip or other damage to a front tooth |
| Any other repair after an injury. In the case of an injury, don't
overlook other insurance plans. Medical insurance plans often have a provision for covering
the repair of an injury. Liability plans or workmen's compensation plans that cover the site on which the injury occurred
may also come into play. |
Click here to read more about
cosmetic dentistry and dental
insurance.
|
Cosmetic dentistry | dental insurance
Delta Dental Insurance
Dental insurance | cosmetic dentistry
Dental Plan
Preferred Provider
Tooth Gap
Usual and Customary |
