Dental Coverings: Everything You Need to Know

Introduction: Why Dental Coverings Matter

Dental health is a critical component of overall well-being, yet many people avoid necessary treatment due to cost concerns. That’s where dental coverings—both in the form of physical dental restorations and insurance plans—play a vital role. This article explores the types of dental coverings, how insurance can help offset treatment costs, and what to look for in a dental insurance plan that meets your specific needs.

What Are Dental Coverings?

Definition and Scope

“Dental coverings” can refer to two main categories:

• Restorative coverings like crowns, bridges, veneers, and caps that protect or restore damaged teeth.
• Insurance-based coverings, which determine what procedures and treatments your dental insurance policy pays for.

In this article, we’ll focus primarily on insurance-related dental coverage but will touch on the types of procedures these plans typically include

Types of Dental Coverings (Restorative)

Understanding the procedures your insurance might cover begins with knowing the common types of dental restorations:

Dental Crowns and Bridges

• Crowns cover a damaged or weakened tooth entirely.
• Bridges replace missing teeth by anchoring to adjacent teeth.

Veneers

Veneers are thin shells that cover the front surface of teeth for cosmetic improvements.

Implants and Implant-Supported Prosthetics

Dental implants act as artificial roots, supporting crowns or dentures. These are among the most expensive procedures—and often the most questioned in terms of coverage.

What Delta Dental Typically Covers

• Preventive care: exams, cleanings, X-rays
• Basic services: fillings, simple extractions
• Major services: crowns, root canals, dentures

Delta Dental may cover dental implants, but it largely depends on your specific plan. Check your coverage summary or consult with your provider directly.

Dental Insurance That Covers Implants

Many people are surprised to find out that dental insurance that covers implants is not always standard.

Understanding Coverage Limitations

• Implants are often considered a “major service” and may be partially covered after a waiting period.
• Annual maximums usually cap out around $1,000–$2,000, which is often less than the full cost of an implant procedure.
• Some plans offer implant riders or optional add-ons for broader coverage.

Best Practices for Implant Coverage

• Look for plans that mention implants explicitly in the benefits section.
• Ask if your plan has pre-authorization requirements for implant treatment.
• Consider combining dental and medical insurance options.

How to Get Dental Implants Covered by Medical Insurance

Did you know that in some cases, medical insurance can cover dental implants? It’s rare, but possible.

When Medical Insurance Might Pay

Medical insurance may help cover implant-related procedures if:

• The tooth loss is due to a traumatic accident.
• Implant placement is medically necessary (e.g., for jaw stabilization).
• The procedure is part of reconstructive surgery post-cancer treatment or congenital defect.

Documentation Is Key

To increase the chances of getting your dental implants covered by medical insurance, gather:

• Medical necessity documentation from your dentist or oral surgeon
• X-rays and imaging reports
• Letters of explanation to your insurance provider

Dental Insurance That Covers Orthodontics

Braces and other orthodontic treatments are essential for both function and appearance, yet many policies exclude them.

What to Expect from Orthodontic Coverage

• Coverage is often limited to children under 18.
• Lifetime maximum benefits for orthodontics are typical (e.g., $1,500 per individual).
• Invisalign or clear aligner treatments may not be covered or may have restricted reimbursements.

Adult Orthodontics

If you're looking for dental insurance that covers orthodontics for adults, consider:

• Employer group plans with orthodontic riders
• Standalone orthodontic insurance
• Health savings accounts (HSAs) or flexible spending accounts (FSAs) to offset out-of-pocket costs

What Insurance Covers Dental Implants? A Comparison Guide

If you're wondering what insurance covers dental implants, here's a comparison of some providers:

Key Providers Offering Implant Coverage

When evaluating what insurance covers dental implants, it’s important to compare major providers:

Delta Dental offers implant coverage in some of its plans. However, the level of coverage can vary significantly between PPO and HMO options. It’s crucial to read the plan details or speak directly with a representative to confirm implant benefits.

Cigna Dental typically includes implant coverage, especially in higher-tier plans. These plans are often more comprehensive and offer better reimbursement rates for implant procedures.

Guardian Direct also provides implant coverage, with certain plans even including implant maintenance. This makes it a favorable choice for long-term implant care and follow-up.

Aetna is more limited in terms of implant coverage. In many cases, implants are considered elective and may not be covered at all unless medically necessary.

MetLife offers limited implant coverage, which might come with a waiting period or restrictions on the type of implant procedures eligible for reimbursement. It’s advisable to review the fine print or confirm directly with the provider.

How to Choose the Right Dental Insurance Plan

Factors to Consider

• Network size – Does your dentist accept the plan?
• Coverage levels – Preventive vs. basic vs. major procedures
• Waiting periods – Many plans require 6–12 months for major procedures
• Annual/lifetime limits – These impact high-cost procedures like implants or braces
• Premiums vs. out-of-pocket costs – Sometimes higher monthly fees mean better coverage

Tips for Maximizing Your Dental Coverage

Stay In-Network

Using in-network providers can save you 20–40% compared to out-of-network costs.

Use Preventive Benefits

Most plans cover exams and cleanings at 100%. Use them! Preventive care reduces long-term expenses.

Plan Big Procedures Strategically

If you need multiple costly treatments, consider spacing them across calendar years to maximize your annual benefit limits.

Commonly Asked Questions (FAQs)

Q: How do I know if my plan covers implants or orthodontics?
A: Check the benefit summary or call your provider directly. Look for terms like “major restorative” or “orthodontic services.”

Q: Can I use both dental and medical insurance for a procedure?
A: Yes, if the procedure has a medical component. Proper documentation is required.

Q: What if I don’t have dental insurance?
A: Consider dental savings plans or financing options like CareCredit. Some clinics offer in-house memberships with discounted services.

Take Control of Your Dental Coverage

Understanding the ins and outs of dental coverings can save you thousands and help you plan treatments without financial stress. Whether you're looking for dental insurance that covers implants, orthodontics, or wondering how to get dental implants covered by medical insurance, the key lies in thorough research and smart plan selection.

By asking the right questions and evaluating your coverage options carefully, you’ll be one step closer to a healthier, more confident smile—without breaking the bank.