If you’ve used dental insurance before to help you with the cost of maintaining your oral health, it’s only fair to wonder: can dental insurance cover cosmetic dentistry too? Other resources online may say that dental insurance covers cosmetic dentistry.
However, unfortunately, the answer is “no.” But – as a dentist with over 15 years of experience – I can tell you that despite the lack of insurance coverage, there are a variety of other options you do have when it comes to accessing cosmetic dental care.
In this blog, you’ll learn:
- Whether or not you can get dental insurance for cosmetic dentistry
- How insurance providers categorize treatments
- Alternative ways to save aside from dental insurance
- And more!
Dental insurance plans don’t cover cosmetic treatments
In general – personal, family, and group insurance plans don’t include coverage for cosmetic treatments.
This lack of coverage and inclusion is a product of the way that insurance providers categorize dental treatments: Restorative vs Elective. (More to come on these below!)
Some dental insurance plans have higher premiums, but it is a common misconception that these plans cover cosmetic dental procedures. Rather, the benefit to higher premium plans is that there is usually just a higher annual allowance available.
This is helpful, but only for those who require more extensive restorative treatments, beyond the standard coverage; it does not extend to cosmetic dental care.
In the state of Iowa, once your annual insurance maximum is met, unfortunately, everything is out of pocket for the patient. This is due to our ‘Non-Covered Services law’. Often, there are no additional discounts available, unless the patient is employed by the federal government, or has a self funded plan – (ERISA).
This is why at Lawson Dentistry, we choose to be a non-restricted, non-participating provider. We want to treat all of our patients fairly. Everyone deserves access to the best materials, technology and labs and by extending courtesy discounts to all of our clientele, we are better able to make that happen. Check out our flexible payment options to learn more.
Restorative vs elective dental procedures: what’s the difference?
Insurance providers classify procedures largely on the basis of perceived medical necessity. I usually explain the difference to my patients this way:
A dental treatment is restorative if…
- Its primary purpose is to improve health
- It addresses decay or disease
A dental treatment is elective if…
- Its primary purpose is to improve aesthetics
- It changes the shape or mechanics of a person’s bite
It is a misconception to think that only procedures that have no medical impact, such as cosmetic treatments, are seen as elective, it’s actually the opposite. If it’s a condition caused by a medical condition, it is not covered. This happens in cases where changes to the patients bite are needed.
Dental insurance does not cover changes to the shape and mechanics of a bite. Bite adjustments, otherwise known as equilibration are very rarely included in a plan coverage.
Dental insurance does not see wear, attrition or shortening of teeth as a dental disease because it is most frequently caused by a medical condition. Common conditions include: TMJ, gastric reflux or sleep apnea induced bruxism. Grinding and clenching are now classified under sleep related movement disorders.
What usually counts as a cosmetic procedure?
In my 15+ years as a dentist, these are the procedures which I’ve routinely seen insurance providers classify as cosmetic.
Veneers
Since they are typically used to conceal stains or change the appearance of a smile, they understandably count as cosmetic in nature.
Teeth Whitening
While they make a smile look incredible, they don’t have a significant impact on oral health, putting them squarely in the cosmetic category.
Bonding
Bonding and contouring do affect the structure of a tooth, but don’t change the function of your teeth or your overall health enough to be considered as restorative.
Onlays & Inlays
Dental insurance sometimes covers inlays and onlays, but only if there’s a very strong case that the work will primarily serve a functional, health-related purpose.
Tooth Crowns
Crowns that restore damage and tooth function can receive partial coverage, but crowns that are placed just for stain removal or style purposes won’t be approved.
Are there other ways to save?
Dental insurance is essentially a coupon that may or may not apply based on the service received. It is like any discount at a retailer that has exclusions.
Even though dental insurance can’t always offer financial relief, there are still other options for you to explore which can certainly still help you save on cosmetic treatment.
Health Savings Accounts (HSA) and Flex Money
If you have a high deductible health plan and an HSA or Flex Money, it can be used to directly (and indirectly!) help you save.
Purely cosmetic treatments like teeth whitening aren’t counted as HSA-eligible expenses, but treatments that are both elective and restorative, like orthodontics or dental implants, can be eligible, helping to directly lower your treatment costs.
Alternatively, if you have the funds to cover your treatment up front, you can instead maximize your HSA contributions and use them to accrue tax-free investment savings. Then, later on, you can reimburse yourself – again, tax-free – without affecting your taxable income. With this method, you save indirectly while gaining financial flexibility can be particularly valuable in your retirement years.
Cash or Check Discount
Pay by cash or check and receive a 5% discount on your treatment. Some restrictions may apply, call us for more details.
Membership Plan
At Lawson Dentistry, we offer an in-house membership plan which helps our patients save on dental care and select treatments. While our Membership plans don’t include cosmetic dentistry, they can help you save on other services.
Our Membership plans offer excellent value for routine care. We help you save on the basics like oral exams, cleanings, and emergency care.
With our plans you get:
- 10% off all eligible treatments performed at our dental office
- 5% off for family members added to an existing subscription
Visit our Membership Plans page to learn more!
Healthcare Credit Cards
Third-party financing can make cosmetic treatment more immediately accessible, but the interest that comes with it also raises your total treatment cost.
With a healthcare credit card from a provider like CareCredit, you can still invest in your smile while avoiding added charges as long as you stay on track with your monthly minimums.
Discount Plans
Available for an annual subscription fee, discount plans like the ones offered by Aetna and Careington give you access to percentage reductions (typically in the 15-20% range) on cosmetic treatments.
To summarize
- Veneers, whitening, bonding, tooth crowns, and onlays & inlays typically aren’t covered by dental insurance.
- You can still save on cosmetic care with discount plans, healthcare credit cards, or a healthcare savings account.
- If you’re not sure what your insurance plan covers, you should always take the time to ask.
An investment in your smile
Cosmetic dentistry gives you a sense of confidence like few other things can.
Getting the results you want, however, takes investment. There’s the time you need to dedicate to finding the right dentist and receiving the treatment, and – of course – the cost of the treatment itself.
Making everything work isn’t always simple or easy, but – when you look in the mirror and finally see a smile that you love – it absolutely is worth the time, effort, and funds you put into it.
Let’s talk about your options
If you live here in Urbandale or anywhere in Des Moines, and you’re looking for a dentist to help you make a decision that’s right for your smile, your health, and your finances, it’d be my pleasure to help.
With a complimentary consultation, I can assess your smile and help you understand what your treatment options are. It’s as easy as calling Lawson Dentistry at (515) 278-4366 or by sending me a message online.
