Does Dental Insurance Cover Crowns? Many people are asking themselves this question as they face the reality of needing dental work. The answer may surprise you.
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Types of Dental Plans
When you purchase dental insurance, you will be choosing from among several types of dental plans. The three most common types of dental insurance are HMOs, PPOs, and indemnity plans. HMOs (health maintenance organizations) are the least expensive type of dental insurance. With an HMO, you must choose a primary care dentist (PCD) from among the dentists in the HMO’s network. Your PCD will be your main resource for all dental services, including routine care, fillings, and extractions. You can see dentists outside of the HMO’s network for services that are not covered by your HMO plan, but you will have to pay the full cost of these services out-of-pocket. PPOs (preferred provider organizations) offer a wider selection of dentists than HMOs, but they are more expensive. With a PPO plan, you can see any dentist you want; however, you will save money if you choose a dentist from within the PPO’s network. Dentists who participate in a PPO usually agree to charge lower fees for their services. Indemnity plans are the most expensive type of dental insurance. With an indemnity plan, you can see any dentist you want; however, you will have to pay the full cost of your dental care out-of-pocket and then submit a claim to your insurance company for reimbursement.
Coverage for Crowns
Most dental insurance policies will cover the cost of a crown to a certain extent. The coverage may be based on a percentage of the cost or a fixed amount. For example, your policy may pay 50% of the cost of a crown or $500 per tooth.
In-Network Coverage
If your insurance plan is through a private company, you will have what is called an in-network dentist. In-network dentists are dentists that have contracted with your insurance company to provide services at a discounted rate. Most insurance companies will only cover a portion of the costs associated with in-network dental care, and you will be responsible for the remaining balance. The amount that your insurance company covers will depend on your particular plan. Some plans cover as much as 80% of the costs associated with in-network dental care, while others only cover 50%. You should check with your insurance company to find out what percentage of in-network dental care they cover. Even if your insurance plan covers a portion of the costs associated with in-network dental care, you may still be responsible for paying a significant amount out-of-pocket. For this reason, it is important to check with your dentist to find out what their fees are before you schedule an appointment.
Out-of-Network Coverage
If you choose to visit an out-of-network dentist, you may still be able to get some coverage for your crown. For example, if you have a Preferred Provider Organization (PPO) plan, you may be reimbursed a percentage of the billed charges for an out-of-network procedure. The percentage you’re reimbursed depends on your particular plan. But if you have a Health Maintenance Organization (HMO) plan, you’ll likely only be covered for emergency or urgent care from an out-of-network dentist, and even then, only if your regular dentist refers you. If you aren’t sure what type of plan you have, check with your dental insurance provider. With either type of plan, it’s always a good idea to check with your insurer beforehand to see what kind of coverage and reimbursement you can expect for an out-of-network procedure like a crown.
How to Save on Dental Crowns
Dental insurance can save you money on dental crowns. Many policies cover the entire cost of the procedure. Some policies may have a copayment, and some may require that you pay a percentage of the cost. There are a few things you should know about dental insurance and dental crowns.
Compare Dental Plans
Dental insurance plans do not typically cover cosmetic procedures like teeth whitening. However, some plans will cover dental crowns if they are deemed medically necessary. If you are considering getting dental crowns, be sure to check with your insurance company to see if they offer coverage. There are a variety of ways to save on dental crowns, including: -Asking your dentist if they offer discounts for cash payments -Checking to see if your dental insurance plan offers coverage for crowns -Comparison shopping for the best price on dental crowns -Looking into dental financing options
Use a Dental Discount Plan
If you don’t have dental insurance or your dental insurance doesn’t cover dental crowns, another way to reduce the cost of dental crowns is to join a dental discount plan. Dental discount plans are not dental insurance, but they can save you 10% to 60% on the cost of dental procedures, including crowns. With a dental discount plan, you pay an annual fee for access to a network of dentists who have agreed to provide discounted services to plan members. You can usually find a wide variety of dentists in the provider network, including general dentists and specialists. You can also usually browse the list of participating dentists online before you join a plan.
