As an increasing number of people seek out cosmetic dental procedures, insurance that covers cosmetic dentistry is in higher demand. But is it accessible?
When looking for dental insurance plans, you have likely noticed one frustrating detail. Most dental insurance policies don’t provide coverage for cosmetic procedures. Finding an insurance policy that offers full coverage is best, particularly if you have a lot of cosmetic issues you want to address.
Let’s take a look at what cosmetic dentistry is, and how to get insurance that covers it.
Cosmetic dentistry is a group of dental treatments aimed solely at improving the appearance of your smile.
Whitening, bonding, veneers, and implants are some cosmetic treatments that can also be classified as restorative services, which aim to correct damage after injury or illness.
Full coverage dental insurance covers basic and major services, including preventive services and routine X-rays—alongside restorative services and orthodontic care.
Most types of dental insurance do not cover services only intended to improve your appearance.
The best dental insurance plans might be savings plans that have no waiting period, annual maximum, or deductibles, just discounted services.
Cosmetic dentistry is a category of dental procedures that aren’t performed for medical purposes. From teeth whitening to major restorative care, their intent is to improve the appearance of your teeth. Cosmetic dental services make teeth whiter, straighter, or visually correct defects such as cracked, chipped, missing, or eroded teeth.
Some people seek out cosmetic procedures to correct an injury or congenital defect, such as replacing a tooth that never developed during childhood. Others aim for the “perfect” white, even appearance made more popular by social media influencers [1].
Cosmetic dentistry covers all procedures that benefit your appearance, but aren’t medically necessary, such as whitening or visually correcting chipped teeth.
The main procedures seen in cosmetic dental care are:
Bleaching is a method of whitening teeth, where hydrogen peroxide solutions are used to strip stains of their color. When peroxide breaks down, oxygen is released, and the free radicals generated break stains down into non-colored substances [2].
According to CostHelper, over-the-counter products may cost anywhere from $20–$100, while the average bleaching treatment from a dentist’s office costs $500–$700 [3].
Dental bonding corrects small defects in teeth, including cracks, chips, excessive space between teeth, and spot stains. Like veneers, they generally use resin composite material.
The average cost of cosmetic dental bonding is $300–$600 per tooth, but this can range anywhere from $100 to over $1,000 depending on your needs and your dentist’s experience [4].
Dental crowns are also known as caps. This is thanks to their role as a tooth-shaped shell that protects weak or damaged teeth; or restores the appearance of a small, discolored, or broken tooth. You may receive them alongside bridges, which are fixed prosthetics intending to fill gaps made by at least one missing tooth.
Patients with no insurance often pay between $875–$1,400 for porcelain fused to metal crowns, and up to $3,000 for each all-porcelain crown [5]. The average cost of bridges ranges from $1,100–$2,300 for one false tooth, or up to $3,500 for two false teeth [6].
Implants replace missing teeth after tooth extractions, injuries, or congenital issues where they do not correctly form. Here, a false tooth is fixed to the jaw bone by a metal screw.
The average out-of-pocket costs for dental implants are $2,500 per tooth, but prices of $90,000 or more have even been reported when the whole set of teeth must be replaced [7]. As the most expensive procedure, this is where taking the time to find insurance with a strong major dental work coverage is worthwhile, even when you must add on a waiting period.
Gum contouring removes excess gum tissue that develops after some illnesses or use of specific pharmaceutical drugs. Your gums are then reshaped to restore a natural, healthy look.
Prices of $50–$350 have been quoted for gum contouring on a single tooth, but treating all visible front teeth may set you back $3,000 or more without insurance coverage [8].
Teeth straightening is an orthodontic treatment that can involve either traditional metal braces or clear aligners. Both use gradual, consistent force to shift teeth into a straighter position.
This procedure costs an average of $5,000, but you are more likely to get coverage as it may be classed as orthodontic care, not a cosmetic treatment [9].
Whitening services from a dentist involve peroxide solutions of higher concentrations (15% to over 40%), protection of the untreated teeth, and sometimes LED lights or lasers to speed up or improve the whitening process.
The average cost of in-office whitening procedures is $500–$700, but it’s not uncommon to see prices over $1,000 [10].
Veneers are resin composite or porcelain shells that are designed to look like healthy, “perfect” teeth. To apply them, your natural teeth must first be worn down by approximately 0.5mm, and they are then adhered to your teeth with a bonding agent.
Traditional dental veneers cost $500–$1,100 per tooth on average, while types that require little to no enamel loss (Lumineers) set you back by $700–$1,300 for each tooth [11].
Cosmetic dental procedures range from straightening or whitening your teeth to partially or completely replacing lost or damaged teeth. Treatment costs may be as little as $100 or approaching $100,000.
Unfortunately, it is rare for most types of dental insurance plans to cover cosmetic work, even when there is dental coverage for the same treatment types under different indications. Full coverage dental insurance does not necessarily indicate support for cosmetic dentistry.
“Full coverage” dental insurance plans cover preventive dental care, basic services, major dental work including restorations, and orthodontic treatments. Preventive services include cleaning and examinations, while basic services include treatments such as fillings, and major services include crowns for restorative purposes. There should be provisions for dental emergency care.
Even in some of the Gold and Platinum level qualified health plans offered in the Affordable Care Act marketplace, full coverage dental insurance is unavailable to adults. Their annual maximums and monthly premiums are higher, and annual deductibles are lower, but covered services do not change. You will likely still find a waiting period too.
You may find that your dental insurance plan will provide coverage under specific conditions for some treatments. The Preventive Plus Plan by Guardian Direct covers more basic restorative care, such as certain types of crowns and resin restorations. Some major dental work and restorative services are not covered at all. Select does cover major restorative care, but only for medical reasons excluding congenital defects.
To learn more about what Gold and Platinum insurance can do for you as full coverage dental plans, read this article on metal dental insurance plan levels.
Even those that appear to be the best dental insurance plans with the highest monthly premiums do not always cover cosmetic services, as it is rare to find support for this type of treatment.
It is possible to find types of dental insurance plans that cover some cosmetic treatments in limited circumstances. However, you are unlikely to find plans with no waiting period.
AARP Delta Dental Plan A covers many basic and major services right away. There is a six-month waiting period for whitening treatments, then they become a full coverage dental service.
At 12 months, implants, crowns, and veneers are eligible for 50% coverage, alongside dentures, TMJ treatments, and gum treatment. Unfortunately, the benefits you unlock after the 12-month waiting period are restorative only.
This plan is a PPO dental insurance plan, which differs from a dental HMO in that you aren’t restricted to in-network dentists. However, using in-network providers will mean a cheaper price on everything from basic dental services to major services.
Some insurance companies provide Dental Access Plans. These are different from full coverage dental insurance plans, in that they are cheaper and give you access to discounts instead of reimbursements. For example, the Aetna Dental Access Network plan allows discounts of 15–50% for basic and major services, as well as specialist care.
When we look at this plan as an example, there is no annual deductible, maximum benefit, or annual maximum. It is also one of the plans with no waiting period for all services. Although you do not have full coverage dental insurance, you can still save hundreds or even thousands of dollars on cosmetic dentistry. Whitening, veneers, bonding, and implants are mentioned.
The Care 500 Series by Careington is another example of a dental plan that can give you access to discounted cosmetic dentistry. You can start saving 20–60% of the usual dental care costs immediately, with no waiting period for any service. This plan works by recruiting hundreds of general dentists and specialists across the USA, who agree to provide discounted services.
Like Aetna’s dental care plan also provided by 1Dental, you have the security of fixed prices listed by a fee schedule, as long as you choose an in-network dentist. The only exceptions to their coverage within this nationwide network are treatments already in progress, such as if you have braces or at-home clear aligners.
Many dental insurance plans do cover restorative dentistry, which is indicated after injury, accidents, or illness. Dental plans prioritize treatments that aim to restore function, such as the ability to talk or eat. Procedures used in cosmetic dentistry are therefore typically part of covered dental care when there is a medical reason for its use, and coverage begins after a waiting period.
There must be issues such as pain or loss of function besides dissatisfaction with your appearance. Simply being unhappy with your appearance or feeling that you require cosmetic enhancement for professional reasons does not make you eligible for insurance coverage.
Cosmetic dentistry in the truest sense is intended to improve the appearance of your teeth. Restorative dentistry will apply many of the same procedures, such as veneers or crowns, to protect weakened or damaged teeth for medical reasons.
For example, a cracked, chipped, missing, or decayed tooth can require dental policies to cover you for a crown or veneer. If your teeth are stained or feature gaps that you are unhappy with, you won’t be covered if they are otherwise healthy.
Even a full coverage dental plan won’t reimburse you for major dental work with a purely cosmetic purpose. However, treatment at least partly for restorative purposes, as well as dental plans providing discounts, can help you save if there are fair annual maximums.
With no waiting period, you can pursue the dental care of your choice as soon as your insurance or other type of dental plan becomes active.
Many plans require you to wait for six or even 12 months for some dental services to be covered. For example, the Aetna plan has a six-month waiting period before you can receive coverage for whitening teeth. Your insurance company will specify which treatments have no waiting period, and those that become eligible for reimbursement right away.
Both dental plans mentioned above, however, allow you to claim discounts from in-network dentists without a waiting period. Neither counts as a true dental insurance plan, but discounts for diagnostic services, basic care, preventive care, and major services may be comparable to coverage you can find elsewhere. The difference is that you save on cosmetic care too.
Dental plans with no waiting period are available for cosmetic uses, but “true” insurance commonly enforces a waiting period for minor and major restorative procedures.
What are the most important things you need to know about cosmetic dental insurance?
Finding full coverage dental plans that provide reimbursements for cosmetic care can feel like searching for the proverbial needle in a haystack. Generally, you will only find insurance that covers cosmetic dentistry when it is primarily for restorative purposes, such as crowns or veneers to protect a damaged tooth.
If you are unhappy with your appearance but don’t have any medical reason to seek treatment, such as whitening or veneers, there are still options. These are mainly in the form of Dental Access Plans. With no waiting periods and significant discounts for all services, you may find these the best options for you.
