Taking care of your dental health is an essential part of maintaining a good quality of life and enhancing your overall well-being.

But even if you keep up with your regular cleaning appointments, dental exams, and practice excellent dental hygiene at home, there’s still a chance you may need a dental crown to repair a damaged tooth at some point in your life.

And despite being an important dental procedure for many patients each year, health insurance companies often fail to cover the cost of dental crowns, leaving the patient to foot a hefty bill.

Thankfully, there are a few ways to ensure that you get the insurance coverage you deserve, no matter what dental services you need.

What are Dental Crowns?

Dental crowns, also known as dental caps, are a type of permanent dental fixture that goes on over a cracked or otherwise damaged tooth or implant to prevent further destruction to that tooth and the ones around it.

While there are many different types of dental crowns, the most common materials used today are metal, porcelain, resin, or porcelain-fused-to-metal, which each offer their own unique set of advantages or disadvantages.

You may need a dental crown if you experience

  • An old filling that has become loose
  • Teeth that have been cracked or chipped due to injury
  • Serious tooth decay resulting from a cavity
  • Root canals that require additional tooth protection
  • Cosmetic dental procedures that need to be discreetly covered

Whatever the case may be, you’ll need to speak with your dentist about your dental crown options, so that you can find the right solution to meet your needs.

Does insurance cover Dental Crowns?

In short, yes.

However, there are many stipulations that your insurance company may use to reduce the amount of coverage that can be applied towards your dental crown, driving up your out-of-pocket costs and potentially delaying your ability to get the dental care you deserve in a timely manner.

The most common hurdle that patients are faced with when applying for a dental crown is whether or not your insurance company considers the procedure to be medically necessary.

In other words, unless your cracked tooth is an immediate threat to your health, your insurance may be able to reject covering your dental procedure.

Here’s what you need to know before you ask your insurance company to cover your dental crown

Network Dentist

Just like with major health insurance, your insurance company will likely ask you to choose from their network of dentists before you can get your crown or any other dental procedures. This can provide a challenge for patients, since many dental offices have lengthy waitlists before accepting new clients.

If you’re unable to put off your dental crown, or you’d simply like to choose your own dentist, your dental insurance may not cover your expenses.

Annual Maximum

Whether you have private insurance, government-funded, or military coverage, most insurance companies include an annual maximum that can determine how much they’ll cover for all of your dental services each year. On average, the standard annual maximum in the United States is $1,500, which can make it a challenge to get the dental procedures you need without going over your limit.

If you require only basic care, then you probably won’t exceed your annual maximum. However, if you’re ever in need of additional procedures, you’ll likely have to cover the remaining costs yourself.

Coverage Types

Another important factor to consider is the different types of dental coverage that your plan will cover. Usually, there are 3 main types of coverage included in most dental insurance plans: Preventative, Basic, and Major Procedures.

Preventative care, which includes your regular cleaning appointments, X-rays, and sealants, covers 100% of the costs associated with these services, since they’re considered medically necessary for good dental health.

Basic care, which includes fillings, tooth extractions, and gum disease treatments, is usually covered up to 80% by your insurance company. While these dental services are important, many plans don’t deem them to be medically necessary.

Major care, which includes root canals, dentures, bridges, and crowns, is often covered only up to 50%. In many cases, your insurance company will consider these procedures to be “elective,” so they may not be included in your coverage.

Waiting Period

Finally, many insurance companies will require a waiting period before you can receive your crown or other dental procedures, especially if you are a new patient. This process can last anywhere from 12 months to 2 years, which can lead to further tooth decay if you aren’t able to get the care that you need.

How much do Dental Crowns cost?

While the cost of a dental crown may vary depending on the state you live, crowns typically range between $500 – $2,000 per tooth.

That means that if your plans offer only 50% coverage for a single crown, you could still be spending anywhere from a few hundred to several thousands of dollars on your procedure, depending on how many teeth need to be covered, the severity of the tooth damage and the type of crown your dentist decides to use.

What if I don’t have dental insurance?

Even with dental insurance coverage, you can still find yourself paying significant out-of-pocket costs for the sake of your dental health.

But thankfully, dental offices like East Valley Dental Professionals have developed a modern alternative to dental insurance that can save you and your family thousands of dollars each year on all types of dental services.

Our individual dental membership plans were designed to give our patients the dental care they deserve at an affordable cost, without jumping through all the hoops that most insurance companies require.

Here’s what our monthly dental memberships can do for you

Total Basic Care Coverage

When you sign up for your monthly plan, you gain immediate access to all of the basic dental care you need for a healthy, vibrant smile. Our plans include cleanings, fillings, x-rays, and exams at no additional cost each month, no matter how many visits you need to make.

Exclusive Procedure Discounts

Our goal is to ensure that no patients ever have to go without the critical care that they need. That’s why our plans offer significant discounts for major dental procedures that may not be covered by traditional insurance, including dental crowns and root canals, so you never have to put off repairing a damaged tooth.

No Maximums Or Deductibles

We guarantee that our patients pay a transparent monthly rate, with no annual maximums, long waiting periods, or costly deductibles required. As long as you choose our in-house dentists, we’ll make sure that you never have to deal with the hassle of insurance coverage again.

Ready to get the dental care you deserve?

At EVDP, we know that dealing with a surprise dental procedure can be a stressful experience, especially if your insurance company isn’t willing to help you cover the cost.

We’re committed to helping our patients receive high-quality care for all of their dental health needs, regardless of what their budget looks like.

Learn more about how our monthly dental memberships can help you transform your smile today by calling our office today at (430) 838-3033.