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Procedure typically covered under your dental plan (Part IV)

Are dental regular cleanings covered by insurance? Preventative care is typically cheaper than dealing with the ravages of periodontal disease or other dental issues. To that end, most dental plans offer coverage for the following:

  • Twice-yearly dental exams (may require a co-pay)

  • Dental x-rays, commonly offered once every two years

  • Dental fillings

  • Root canals

  • Tooth extractions

  • Bridges, crowns, implants

  • Emergency dental care

  • Dental appliances

Keep in mind not all of these procedures are covered fully. Dental procedures are divided into four categories, preventative, diagnostic, major, and basic.

Preventative and diagnostic procedures are often covered at 100%. This includes regular dental exams, professional cleanings, and dental x-rays.

Basic procedures are covered at 80% and major procedures at 50%. Major procedures include crowns, bridges, dentures, and other similar procedures.

Basic procedures include fillings, root canals, oral surgery, and periodontal care. All of these except fillings can be considered major procedures as well. It depends on the severity of your situation.

Dental bonding is also typically covered. However, if the tooth needs bonding as a result of an accident, you’ll be encouraged to use your medical insurance first.


What procedures typically aren’t covered?

There is also a list of dental procedures that insurance typically doesn’t cover. Much of the determination is based on medical necessity.

For example, you may need a crown to hold together a broken tooth and help to prevent further damage and that would be covered. However, a veneer over a chipped tooth serves a primarily cosmetic purpose. For this reason, veneers are almost never covered.

Another good example is that dental plans will cover silver-colored amalgam fillings based on medical need. However, if you want more expensive tooth-colored composite fillings, you’re going to have to pay the extra cost for those.



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