Approximately 50% of Americans with private insurance have dental coverage, but it generally does not cover any sort of cosmetic procedures, including teeth whitening. Dental insurance has a typical annual maximum amounting to a median of $1,500. It covers procedures strictly related to health and wellness, and it has a three-tier structure known as 100-80-50.
- Most dental insurance policies do not cover any cosmetic treatments.
- There are three types of coverage generally covered by dental insurance—preventive, basic care, and major work.
- Dental plans typically cover either semi-annual or annual visits for cleanings, as well as sealants, and X-rays.
What Does Dental Insurance Typically Cover?
Preventive care—such as annual cleanings, X-rays, and sealants—are covered fully. Basic procedures—such as fillings, extractions, and periodontal treatment for gum disease—are covered 80%. Major procedures—crowns, bridges, inlays, and dentures—are covered 50%. Depending on your plan, root canals can fall into either the basic or major category. Most plans focus on preventive and basic care, and not all procedures are covered.
Dental Insurance Does Not Cover Cosmetic Procedures
Most dental insurance policies do not cover any costs for cosmetic procedures, such as teeth whitening, tooth shaping, veneers, and gum contouring. Because these procedures are intended to simply improve the look of your teeth, they are not considered medically necessary and must be paid for entirely by the patient.
Some dental practices offer payment plans to help patients afford cosmetic work such as veneers, whitening treatments, and, in some cases, even braces.
What Constitutes Cosmetic Dentistry?
Cosmetic dentistry includes procedures that exist for the main purpose of improving the appearance of the patient’s teeth and smile. Whitening treatments, veneers, bonding, and straightening procedures, such as Invisalign, are included in this group. These procedures, while widely known and quite popular, tend not to be covered by insurance and require the patient to pay the entire cost.
The Bottom Line
According to the Consumer Guide to Dentistry, in-office teeth whitening costs, on average, $650, compared with $400 for take-home trays and under $100 for over-the-counter bleaching trays or strips.
The price increases or decreases depending on location and office pricing. As insurance is not involved, there isn’t a usual and customary fee, which is why the pricing varies from office to office.
Because of the high price for cosmetic procedures, patients must research other payment options. While many cosmetic dental or orthodontic offices are familiar with offering their patients different payment plans, patients can also opt to charge their procedures to zero-interest or low-interest health care credit cards.