Does Insurance Cover Crowns?

Crowns are a common dental treatment that helps to restore damaged teeth, and it can be quite expensive. It’s common to wonder whether insurance covers crowns or not. In this article, we will explore the different types of insurance policies that can cover crowns, the factors that affect insurance coverage, and frequently asked questions about crowns.

Types of Insurance Policies That Cover Crowns

There are two main types of insurance policies that can cover the cost of crowns:

1. Dental Insurance

Dental insurance is a type of insurance that covers the cost of dental procedures, including crowns. However, the level of coverage can vary depending on your insurance policy.

Typically, dental insurance policies have annual maximums. This means that there is a cap on how much the insurance company will pay for dental procedures in a year. For example, if your annual maximum is $1,500, and the cost of your crown is $1,000, then your insurance will cover $1,000, and you will be responsible for the remaining $500.

Additionally, some dental insurance policies may have waiting periods before coverage for major dental procedures, such as crowns, kicks in. So, it’s essential to review your policy before getting a crown.

2. Medical Insurance

Medical insurance may also cover the cost of a crown if the procedure is deemed medically necessary. For example, if you have a broken tooth that is causing severe pain, your medical insurance policy may cover the cost of a crown as a necessary treatment.

However, medical insurance policies may have higher deductibles and out-of-pocket expenses than dental insurance policies. So, it’s essential to check with your insurance company to understand the costs you will be responsible for.

Factors That Affect Insurance Coverage for Crowns

Several factors can affect the coverage of crowns under your insurance policy. They include:

1. Type of Insurance Policy

As discussed earlier, the type of insurance policy you have can determine the level of coverage you get for crowns. Dental insurance policies typically have better coverage for dental procedures than medical insurance policies.

2. Level of Coverage

The level of coverage you have also affects the amount your insurance company will pay for a crown. Some insurance policies may have higher deductibles, which means you will be responsible for more out-of-pocket expenses.

3. Reason for the Crown

Insurance policies may only cover the cost of a crown if it is deemed medically necessary. So, if you want a crown for cosmetic purposes, you may not be covered under your insurance policy.

FAQ: Frequently Asked Questions About Crowns

Here are some frequently asked questions about crowns:

Conclusion

Crowns are a common dental procedure that can be expensive. Dental and medical insurance policies can cover the cost of a crown, but the level of coverage can vary depending on several factors, including the insurance policy and the reason for the crown. If you’re considering getting a crown, it’s essential to review your insurance policy and understand the costs you will be responsible for. Lastly, always discuss with your dental or medical professional if you’re unsure if a crown is necessary for your treatment.