The dental veneers are a popular solution for improving the appearance of teeth. However, their cosmetic nature raises an important question, does dental insurance cover veneers? In this in-depth guide, we’ll look at veneer coverage and whether or not your dental insurance will help pay for veneers.
Does Dental Insurance Cover Veneers?
The short answer is, it depends. Veneers coverage with dental insurance depends on your insurance provider, the specific plan you have, and why you need veneers. Veneers are usually considered cosmetic and most dental insurance policies exclude them from coverage. Some insurance does cover veneers if they are deemed medically necessary though.
What Are Dental Veneers?
Dental veneers are shells, thin as porcelain or composite resin, that are created to cover the front of teeth. They change the color, shape, size, or length of the teeth. Veneers are often used to correct:
- Discoloration
- Chipped or broken teeth
- Irregularly shaped or uneven teeth.
- Gaps between teeth
How to Know if Your Insurance Covers Veneers
To find out if your dental insurance covers veneers, follow these steps:
1. Review Your Policy:
Find out if your dental insurance plan mentions veneers or cosmetic procedures. Check for terms such as “medical necessity” or “reconstructive services.”
2. Speak with Your Dentist:
Your dentist can also help you determine if veneers are medically necessary and will support this information with documentation to send to your insurance company.
3. Contact Your Insurance Provider:
Ask your insurance company if your plan covers veneers by calling directly. Make sure you ask about pre-authorization and documentation requirements.
Cosmetic vs. Medically Necessary Veneers
If the procedure is considered cosmetic or medically necessary, it’s the key factor in whether dental insurance will cover veneers.
1-Cosmetic Veneers
There are these purely for aesthetic purposes, like whitening teeth or fixing minor flaws. These types of veneers will not be covered by most dental insurance.
2-Medically Necessary Veneers
Veneers may be needed to restore damaged teeth because of injury, disease, or other medical conditions in some cases. If the dentist can justify that veneers are necessary for oral health and function, there is a possibility that dental insurance may cover part of the cost.
Veneers and Insurance: When It Might Pay to Get Them
Dental insurance does not usually cover veneers for cosmetic purposes, but there are some exceptions. These include:
- Accidents or Injuries: Veneers may be covered, as part of reconstructive work, by your dental insurance if your teeth are damaged in an accident.
- Tooth Decay or Damage: But if a veneer is needed to restore a tooth’s structure and function if it is severely decayed or damaged, insurance may help towards the cost.
- Health Conditions: Dental insurance may cover the veneer treatment in cases when a medical condition affects your teeth, such as enamel erosion from acid reflux or bulimia.
How Much Are Veneers Without Insurance?
If your dental insurance doesn’t pay for veneers, you’ll be on the hook for the full price. Veneer prices range from dentist to dentist and depend on the material used. On average:
- Porcelain Veneers: $900 to $2,500 per tooth
- Composite Veneers: $400 to $1,500 per tooth
Composite veneers cost less but they don’t look as natural and don’t last as long as porcelain veneers.
Veneers Financing Alternatives
If your insurance doesn’t cover veneers, there are alternative ways to make the cost more manageable:
1. Payment Plans
Many dental offices will allow you to pay for veneers over time with little or no interest.
2. Dental Savings Plans
An annual membership fee includes discounts on dental services such as veneers. Although they do not have insurance, they can help pay for treatment.
3. CareCredit
The healthcare credit card CareCredit allows patients to finance dental procedures like veneers. With CareCredit, you can pay for veneers every month.
4. Dental Tourism
Others seek to go to other countries where dental work is less expensive. This option may save you money, but you’ll want to do your research and choose a reputable clinic.
Case Studies: Veneers and Dental Insurance: When They Covered Each Other
Let’s explore a few examples where dental insurance did cover veneers:
- John’s Accident: John’s front teeth were chipped after a biking accident. As part of his reconstructive treatment, his dentist suggested veneers. John’s insurance covered 50% of the cost because the veneers were medically necessary to restore his smile and bite.
- Sarah’s Tooth Decay: Sarah’s teeth had been so badly damaged by years of untreated tooth decay that it was impossible to save her front teeth. The dentist suggested that she get veneers to bring her teeth back to normal function and appearance. The veneers were necessary to save Sarah’s oral health, and that treatment cost was helped by Sarah’s insurance.
How to Get Insurance to Cover Veneers
If you believe veneers are medically necessary for your situation, here are a few tips to increase the likelihood of getting insurance coverage:
1. Get Pre-Authorization
Before you are treated with veneers, your dentist must request pre-authorization from your insurance company. They can then review the procedure and decide if it meets the criteria that they require coverage for.
2. Submit Detailed Documentation
Make sure the dentist is detailed in the paperwork as to why veneers are needed. X-rays, photos, and notes on the medical reasons for the procedure might be included.
3. Appeal Denied Claims
When your insurance company denies your claim, don’t give up if you don’t agree with the decision you can request more information or get a second opinion from another dentist.
Conclusion: Does Dental Insurance Cover Veneers?
Dental insurance does cover veneers, right? Veneers are commonly considered cosmetic, and not covered by dental insurance in most situations. If veneers are medically necessary, there’s a chance insurance will help cover part of the cost. Make sure to check your policy, speak to your dentist, and call your insurance company to learn what options you have with coverage.
Some insurance companies will cover your veneers, but you will find there are many ways to make the treatment more affordable, from payment plans to dental savings plans. The more you know about veneer coverage, the better you can make decisions about your dental health and your money.